Individual provider Active NPI

Victoria Richardson, PT

  • Physical Therapist
  • Covington, LA
National Provider Identifier
1083243398
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
01392 Issued in LA
Practice address
1200 Pinnacle Pkwy
Covington, LA 70433-9167
Phone
(985) 674-1700
Fax
(985) 674-1722
NPI assigned
Apr 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 01392 LA Primary

Addresses

Primary practice location

1200 Pinnacle Pkwy
Covington, LA 70433-9167

Mailing address

1200 Pinnacle Pkwy
Covington, LA 70433-9167
Phone (985) 674-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200421002641 LA Practitioner - Physical Therapist in Private Practice 2264862994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avala Physician Network LLCGroup PAC ID 8527472422, 12 clinicians

Practice addresses (Care Compare)

67252 Industry LN
Covington, LA 70433-8704
Phone (985) 801-0259

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avala Physician Network, LLC CurrentSince Jun 22, 2022 Accepting new patients

Locations

67252 Industry Ln
Covington, LA 70433
Phone (985) 801-0259

1200 Pinnacle Pkwy
Covington, LA 70433
Phone (985) 674-1700

1200 Pinnacle Pkwy
Ste 3
Covington, LA 70433
Phone (985) 674-1700

1200 Pinnacle Pkwy
Ste 6
Covington, LA 70433
Phone (985) 892-0305

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1083243398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PINNACLE PKWY",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704339167",
            "telephone_number": "985-674-1700",
            "fax_number": "985-674-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PINNACLE PKWY",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704339167",
            "telephone_number": "985-674-1700",
            "fax_number": "985-674-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "VICTORIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "01392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.