Individual provider Active NPI

Victoria Magnuson, PT, DPT

  • Physical Therapist
  • Fort Walton Beach, FL
National Provider Identifier
1194367763
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
34832 Issued in FL
Practice address
405 Racetrack Rd NE Ste 101
Fort Walton Beach, FL 32547-3960
Phone
(850) 863-4747
NPI assigned
Oct 15, 2019
Last updated
Sep 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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 34832 FL Primary

Addresses

Primary practice location

405 Racetrack Rd NE Ste 101
Fort Walton Beach, FL 32547-3960

Mailing address

116 Benarr Ave NW
Fort Walton Beach, FL 32548-4034
Phone (850) 319-2277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34832FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rinehart Brothers Incorporated Physical Therapist CurrentSince Jun 21, 2021 Accepting new patients
Hypermed, LLC Past Accepting new patients

Locations

2300 Jenks Ave
Ste C
Lynn Haven, FL 32444
Phone (850) 248-1600

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1194367763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 BENARR AVE NW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484034",
            "telephone_number": "850-319-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 RACETRACK RD NE STE 101",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325473960",
            "telephone_number": "850-863-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNUSON",
        "first_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2023-09-08",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "34832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.