Virtue Medical PA, PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

VIRTUE MEDICAL PA, PLLC

Practice address

401 Center Court Dr
Bridgeport, TX 76426-2250

Phone

(940) 255-6552

Fax

(940) 202-7058

NPI assigned

Aug 20, 2021

Last updated

Feb 17, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

VIRTUE MEDICAL GROUP, LLCAs reported in NPPES

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

Authorized official

Name

Dani Davis, M.ED

Title

Coo

Phone

(806) 382-5064

Specialties & licenses 5

Addresses

Other names 1

• Virtue Medical PA, PLLC Other name

Tax ID family

Virtue Medical Physical Therapy PLLC2 organizations share this tax ID, including this one

Part of

Virtue Medical Physical Therapy PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Virtue Medical Physical Therapy, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Bridgeport, TX
  • NPI 1760158596
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Virtue Medical Group, LLC

  • Primary Care Clinic/Center
  • Bridgeport, TX
  • NPI 1811661523
  NPPES parent name

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708128000000",
    "number": "1710653548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1500",
            "city": "BRIDGEPORT",
            "state": "TX",
            "postal_code": "764261500",
            "telephone_number": "940-255-6552",
            "fax_number": "940-202-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CENTER COURT DR",
            "city": "BRIDGEPORT",
            "state": "TX",
            "postal_code": "764262250",
            "telephone_number": "940-255-6552",
            "fax_number": "940-202-7058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 W 5th St",
            "address_purpose": "LOCATION",
            "city": "Justin",
            "state": "TX",
            "postal_code": "762479622",
            "country_code": "US",
            "telephone_number": "940-648-1400",
            "fax_number": "940-648-1402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VIRTUE MEDICAL PA, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VIRTUE MEDICAL GROUP, LLC",
        "enumeration_date": "2021-08-20",
        "last_updated": "2024-02-17",
        "certification_date": "2024-02-17",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DANI",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "806-382-5064",
        "authorized_official_credential": "M.ED"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virtue Medical PA, PLLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Virtue Medical PA, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Taloni Rae Chrislynn Stone-Saturnio, PTA
• Mihir Umesh Talati, MD
• Russell J Tanner, P.A.-C
• Chandra Renee Vanvacter, RPH
• Virtue Medical Group, LLC
• Virtue Medical Physical Therapy, PLLC
• Walgreen Co (Walgreens #21463)
• Edwina G Walker
• Jon W Walker, MD
• Morgan Paige Walker, PHARM.D.

• General Practice Physician in Bridgeport, TX
• Providers in Bridgeport, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2024; 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.