Individual provider Active NPI

Victoria Elaine Custer, MD

  • Obstetrics & Gynecology Physician
  • Rome, GA
National Provider Identifier
1689136855
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
96800 Issued in GA
Practice address
15 Riverbend Dr SW Ste 200
Rome, GA 30161-6005
Phone
(706) 291-0884
NPI assigned
Apr 4, 2019
Last updated
Apr 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 96800 GA Primary

Addresses

Primary practice location

15 Riverbend Dr SW Ste 200
Rome, GA 30161-6005

Mailing address

420 E 2ND Ave Ste 103
Rome, GA 30161-3210
Phone (706) 509-3000

Other practice location 1

1242 N Decatur Rd NE
Atlanta, GA 30306-2313
Phone (770) 359-8952

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vcuster2711518@CarolinasHealthcareSystem.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230901002913 GA Practitioner - Obstetrics/Gynecology 6103289426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical College of Georgia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians

Practice addresses (Care Compare)

1025 N Main St
Cedartown, GA 30125-2036
Phone (770) 748-5212

15 Riverbend Dr SW
Rome, GA 30161-6005
Phone (706) 291-0084

304 Turner McCall Blvd SW
Rome, GA 30165-5621
Phone (706) 509-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.9 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Healthcare Management Inc CurrentSince Sep 1, 2023 Accepting new patients
Floyd Healthcare Management Inc CurrentSince Sep 1, 2023 Accepting new patients
Floyd Healthcare Management Inc Past Accepting new patients
Floyd Healthcare Management Inc Past Accepting new patients

Locations

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

15 Riverbend Dr SW
Rome, GA 30161
Phone (706) 291-0084

15 Riverbend Dr SW
Ste 200
Rome, GA 30161
Phone (706) 291-0884

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

Interoperability endpoints

  • Direct secure messaging: vcuster2711518@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1689136855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 2ND AVE STE 103",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613210",
            "telephone_number": "706-509-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RIVERBEND DR SW STE 200",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301616005",
            "telephone_number": "706-291-0884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1242 N Decatur Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303062313",
            "country_code": "US",
            "telephone_number": "770-359-8952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSTER",
        "first_name": "VICTORIA",
        "middle_name": "ELAINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "96800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vcuster2711518@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "N",
            "address_1": "15 Riverbend Dr SW Ste 200",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301616005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.