Individual provider Active NPI

Victoria Tavenner, DPT

  • Physical Therapist
  • Clearwater, FL
National Provider Identifier
1679281968
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT39553 Issued in FL
Practice address
2414 Enterprise Rd
Clearwater, FL 33763-1751
Phone
(727) 796-4345
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT39553 FL Primary

Addresses

Primary practice location

2414 Enterprise Rd
Clearwater, FL 33763-1751

Mailing address

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0915
Phone (813) 978-9700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221115000369 FL Practitioner - Physical Therapist in Private Practice 0042688566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahassee Orthopedic Clinic III PLGroup PAC ID 4284532755, 538 clinicians

Practice addresses (Care Compare)

2414 Enterprise Rd
Florida Orthopaedic Institute
Clearwater, FL 33763-1751
Phone (813) 978-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Musculoskeletal Institute Chartered CurrentSince Nov 14, 2022 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Nov 14, 2022 Accepting new patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Nov 11, 2024 Accepting new patients
Tallahassee Orthopedic Clinic III PL Single Specialty CurrentSince Nov 11, 2024 Accepting new patients
Musculoskeletal Institute Chartered Single Specialty Current Accepting new patients

Locations

2414 Enterprise Rd
Clearwater, FL 33763
Phone (727) 796-4345

2414 Enterprise Rd
Ste 301
Clearwater, FL 33763

2414 Enterprise Rd
Fl Orthopaedic
Clearwater, FL 33763

3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 210-1808

13020 N Telecom Pkwy
Temple Terrace, FL 33637

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

Interoperability endpoints

  • Direct secure messaging: victoria.tavenner.2@18802.direct.athenahealth.com

Organizations & group practices 5

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": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1679281968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370915",
            "telephone_number": "813-978-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2414 ENTERPRISE RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631751",
            "telephone_number": "727-796-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVENNER",
        "first_name": "VICTORIA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT39553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.