Victor Davis Patrick

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4761 Issued in MN

Practice address

625 Snelling Ave N Ste a
Saint Paul, MN 55104-5585

Phone

(651) 363-3111

NPI assigned

Aug 20, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amazing HealthGroup PAC ID 0941687586, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22592/brand/1/csg/1/fhir/r4

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.

• Amazing Health L. L. C.

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Paul, MN
  • NPI 1750043410

  Family

  Medicare reassignment Care Compare group NPD Authorized official
• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  MN

  Medicare reassignment NPD
• Divine Health LLC

  • Family Nurse Practitioner
  • Saint Paul, MN
  • NPI 1871240267
  NPD

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1124494414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 SNELLING AVE N APT A",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045585",
            "telephone_number": "651-363-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 SNELLING AVE N STE A",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045585",
            "telephone_number": "651-363-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "VICTOR",
        "middle_name": "DAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-20",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "4761",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "CNP 4761",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "4761",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pathways to True Freedom Foundation Inc
• Carl A Patow, MD
• Patricia K. Orud, Ma, LP, LLC
• Lynn Kayleigh Patricia, NCTMB
• Emily Anne Patrick
• Autumn Marie Pattee, PA
• Justin Pattee, M.D.
• Sydney Lee Pattee, CNP
• Neve Laura Patterson
• Brian Dean Patty, MD

• Family Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.