Active NPI
Tracy C Videon, PT, ATC
- Physical Therapist
- Bel Air, MD
National Provider Identifier
1225083017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 18162
- Practice address
- 1401 Conowingo Rd
Suite C
Bel Air, MD 21014-1809 - Phone
- (410) 420-2257
- Fax
- (410) 420-2267
- NPI assigned
- May 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 18162 | MD | Primary |
Addresses
Primary practice location
1401 Conowingo Rd
Suite C
Bel Air, MD 21014-1809
Mailing address
1002 Redbrook CT
Bel Air, MD 21014-5577
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18162 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246406400000",
"number": "1225083017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1002 REDBROOK CT",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210145577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 CONOWINGO RD",
"address_2": "SUITE C",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210141809",
"telephone_number": "410-420-2257",
"fax_number": "410-420-2267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDEON",
"first_name": "TRACY",
"middle_name": "C",
"credential": "PT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-23",
"last_updated": "2009-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "18162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bel Air, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.