Eric C Victor, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4645 Issued in OR

Practice address

425 N Main St
Prineville, OR 97754

Phone

(541) 416-7476

Fax

(541) 416-7478

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Idaho State UniversityGroup PAC ID 4688683030, 19 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 and National Provider Directory roles.

• Idaho State University

  • Audiologist
  • Pocatello, ID
  • NPI 1952474777
  Medicare reassignment Care Compare group NPD
• Idaho State University

  • Community/Retail Pharmacy
  • McCammon, ID
  • NPI 1083393284
  NPD
• Idaho State University

  • Primary Care Nurse Practitioner
  • Meridian, ID
  • NPI 1962095711
  NPD
• Advanced Physical Therapy Inc

  • Physical Therapist
  • Anchorage, AK
  • NPI 1437214459
  NPD (past)
• Idaho State University

  • Physical Therapist
  • Pocatello, ID
  • NPI 1356491187
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1467598581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SW INDUSTRIAL WAY",
            "address_2": "SUITE 3",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021093",
            "telephone_number": "541-585-2529",
            "fax_number": "541-585-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N MAIN ST",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "97754",
            "telephone_number": "541-416-7476",
            "fax_number": "541-416-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTOR",
        "first_name": "ERIC",
        "middle_name": "C",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4645",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "229143",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "159333011",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orlando Valiente
• Nicole Van Alstine, CADC-R CRM, PSS
• Michelli Van Wieren, PSS
• Lorena NMN Vargas
• Ryan Bradley Vaughan, QMHA
• Lynn K Vigil, BS; CADC-I
• Walgreen Co
• Andrea Walker, PSS
• William Ward
• Ross E Weakley, LAC

• Physical Therapist in Prineville, OR
• Providers in Prineville, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; 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.