NPIMap

Organization Active NPI

Victory Therapy & Wellness, LLC

  • Physical Therapist
  • Swainsboro, GA
National Provider Identifier
1538588116
Registry record updated Apr 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006038 Issued in GA
Legal business name
VICTORY THERAPY & WELLNESS, LLC
Practice address
114 Victory Dr
Swainsboro, GA 30401-3235
Phone
(478) 237-4017
Fax
(478) 237-3074
NPI assigned
Apr 10, 2014
Last updated
Apr 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2014

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

Authorized official

Name
Dr. William Francis Connor, PTNPI 1669576849
Title
Physical Therapist
Phone
(478) 237-4017

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT006038 GA Primary

Addresses

Primary practice location

114 Victory Dr
Swainsboro, GA 30401-3235

Mailing address

114 Victory Dr
Swainsboro, GA 30401-3235
Phone (478) 237-4017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140516001971 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7517180607 Receives reassigned benefits from 1 practitioner
Practice locations: Swainsboro, GA

National Provider Directory

National Provider Directory

Locations

114 Victory Dr
Swainsboro, GA 30401
Phone (478) 237-4017

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397174400000",
    "number": "1538588116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 VICTORY DR",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304013235",
            "telephone_number": "478-237-4017",
            "fax_number": "478-237-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 VICTORY DR",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304013235",
            "telephone_number": "478-237-4017",
            "fax_number": "478-237-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY THERAPY & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-11",
        "status": "A",
        "authorized_official_last_name": "CONNOR",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "478-237-4017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT006038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swainsboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.