Victoria Clarke Keller, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1035434 Issued in TX

Practice address

519 Elm St
Graham, TX 76450-3037

Phone

(940) 521-0800

Fax

(940) 521-0801

NPI assigned

May 2, 2007

Last updated

Jun 10, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Victoria Clarke Cannella Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thrive Physical Therapy, LLCGroup PAC ID 0143504589, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thrive Physical Therapy, LLC

  • Physical Therapist
  • Graham, TX
  • NPI 1790230415
  Medicare reassignment Care Compare group NPD Authorized official
• Thrive Physical Therapy

  • Physical Therapist
  • Graham, TX
  • NPI 1275864787
  Authorized official Same address or phone

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1407078207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 ELM ST",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764503037",
            "telephone_number": "940-521-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 ELM ST",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764503037",
            "telephone_number": "940-521-0800",
            "fax_number": "940-521-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "VICTORIA",
        "middle_name": "CLARKE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1035434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "CANNELLA",
            "middle_name": "CLARKE",
            "prefix": "MS.",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela Johnson
• Loneta Shawn Jones, LMT
• Steven Kent Jones, MD
• Roy B Jordan, RPH
• Christine Liz Joseph, PHARM.D.
• Audra Kennedy, M.D.
• Edward Stanton Key, D.D.S., M.S.
• Sharla Kay King
• Frederick Koberg, M.D.
• Thomas Earl Labbe, O.D.

• Physical Therapist in Graham, TX
• Providers in Graham, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.