Active NPI
Victor Painter, REEGT
- EEG Specialist/Technologist
- Tyler, TX
National Provider Identifier
1316502917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- EEG Specialist/Technologist
- License
- 6485
- Practice address
- 1356 Old Creek Dr
Tyler, TX 75703-7642 - Phone
- (903) 534-0809
- Fax
- (903) 939-9149
- NPI assigned
- May 8, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X | |||
| Surgical Technologist | 246ZS0410X | |||
| EEG Specialist/Technologist | 246ZE0500X | 6485 | TX | Primary |
Addresses
Primary practice location
1356 Old Creek Dr
Tyler, TX 75703-7642
Mailing address
1356 Old Creek Dr
Tyler, TX 75703-7642
Phone (903) 534-0809
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6485 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557273600000",
"number": "1316502917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1356 OLD CREEK DR",
"city": "TYLER",
"state": "TX",
"postal_code": "757037642",
"telephone_number": "903-534-0809",
"fax_number": "903-939-9149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1356 OLD CREEK DR",
"city": "TYLER",
"state": "TX",
"postal_code": "757037642",
"telephone_number": "903-534-0809",
"fax_number": "903-939-9149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAINTER",
"first_name": "VICTOR",
"credential": "REEGT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-08",
"last_updated": "2019-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "246ZE0600X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": null,
"license": null,
"primary": false
},
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "246ZE0500X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, EEG",
"state": "TX",
"license": "6485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.