Victoria Magnuson, PT, DPT

Key facts

NPI

1194367763

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

34832 (FL)

Practice address

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

Phone

(850) 863-4747

NPI assigned

Oct 15, 2019

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Rinehart Brothers Incorporated Physical Therapist · Lynn Haven, FL · NPI 1982630232
  NPD PHYSICAL THERAPIST
• Hypermed, LLC Undersea and Hyperbaric Medicine (Preventive Medicine) Physician · Panama City Beach, FL · NPI 1780081034
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 8, 2023.

{
    "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": []
}

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All providers in Fort Walton Beach, FL · Physical Therapist in Florida