Individual provider Active NPI

Victoria Ann Champagne

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1215472279
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2016039468 Issued in MO
Practice address
3124 N Swan Rd
Tucson, AZ 85712-1227
Phone
(314) 791-7736
NPI assigned
Dec 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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 2016039468 MO Primary

Addresses

Primary practice location

3124 N Swan Rd
Tucson, AZ 85712-1227

Mailing address

3124 N Swan Rd
Tucson, AZ 85712-1227
Phone (314) 791-7736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221006002098 AZ Practitioner - Physical Therapist in Private Practice 4385020866 Reassigns benefits to 1 organization
I20260422001051 OK Practitioner - Physical Therapist in Private Practice 4385020866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bodycentral Physical Therapy PCGroup PAC ID 2466348701, 43 clinicians
Tulsa Bone and Joint Associates PCGroup PAC ID 9335033802, 91 clinicians

Practice addresses (Care Compare)

1991 E Ajo Way
Suite 149
Tucson, AZ 85713-6269
Phone (520) 325-4002

4802 S 109TH E Ave
Tulsa, OK 74146-5822
Phone (918) 392-1513

4808 S 109TH E Ave
Tulsa, OK 74146-5822
Phone (918) 392-1513

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016039468MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bodycentral Physical Therapy PC CurrentSince Sep 12, 2022 Accepting new patients
Bodycentral Physical Therapy P C CurrentSince Sep 12, 2022 Accepting new patients

Locations

1231 W Warner Rd
Ste 101
Tempe, AZ 85284
Phone (623) 250-3223

1991 E Ajo Way
Ste 149
Tucson, AZ 85713
Phone (520) 485-5454

4811 E Grant Rd
Ste 147
Tucson, AZ 85712
Phone (435) 673-4303

3124 N Swan Rd
Tucson, AZ 85712
Phone (520) 276-1274

Organizations & group practices 3

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": "1483056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1215472279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 N SWAN RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121227",
            "telephone_number": "314-791-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 N SWAN RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121227",
            "telephone_number": "314-791-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPAGNE",
        "first_name": "VICTORIA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-30",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2016039468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.