Austin Vidrine, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10801 Issued in LA

Practice address

2550 Boyd Ave
Fort Worth, TX 76109-1021

Phone

(817) 480-3798

NPI assigned

Feb 26, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1396339628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100991",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761850991",
            "telephone_number": "817-480-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 BOYD AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091021",
            "telephone_number": "817-480-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDRINE",
        "first_name": "AUSTIN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "10801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WWW.WEBPT.COM",
            "affiliation": "Y",
            "endpointDescription": "EMR",
            "affiliationName": "Something Amazing Home Therapy, LLC",
            "address_1": "2550 Boyd Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761091021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nikki Jireh Nissi Victorious
• Victory First Assistants, LLC
• Victory Injury Centers
• Victory Medical Center Fort Worth, LP
• Natalie Vidal Jimenez, MD
• Paige Vidrine, MS, CCC-SLP
• Amanda A Viehmann, APRN
• Vieprecieuses (Sublime Home Healthcare Agency)
• Michele Ann Viere
• Rita Vigil, LMFT

• Physical Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.