Individual provider Active NPI

Victoria Ann Sanden, MPT

  • Physical Therapist
  • Vero Beach, FL
National Provider Identifier
1487863825
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 18645 Issued in FL
Practice address
1715 37TH PL
Suite 302
Vero Beach, FL 32960
Phone
(772) 204-8967
Fax
(772) 337-4758
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 18645 FL Primary

Addresses

Primary practice location

1715 37TH PL
Suite 302
Vero Beach, FL 32960

Mailing address

1715 37TH PL
Suite 302
Vero Beach, FL 32960-4502
Phone (772) 204-8967

Other identifiers 2

IdentifierTypeStateIssuer
651147823OtherFLPREMIER THERAPY TAX ID #
1417067844OtherFLPRACTICE NPI #

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

LicenseStateTypeSpecialty
PT 18645FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Infinity Home Care of District 9 Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1487863825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 37TH PL",
            "address_2": "SUITE 302",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604502",
            "telephone_number": "772-204-8967",
            "fax_number": "772-337-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 37TH PL",
            "address_2": "SUITE 302",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "32960",
            "telephone_number": "772-204-8967",
            "fax_number": "772-337-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDEN",
        "first_name": "VICTORIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 18645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMIER THERAPY TAX ID #",
            "identifier": "651147823",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE NPI #",
            "identifier": "1417067844",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; 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.