Victor Manuel Tolley, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11099798-4405 Issued in UT

Practice address

10 S 2000 E
Salt Lake City, UT 84112-5880

Phone

(801) 413-9222

NPI assigned

Apr 26, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Family MedicalGroup PAC ID 7416197785, 84 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Premier Family Medical

  • Family Medicine Physician
  • Pleasant Grove, UT
  • NPI 1750725735
  Medicare reassignment Care Compare group NPD
• Premier Family Medical - American Fork Physical Therapy

  • Physical Therapy Clinic/Center
  • American Fork, UT
  • NPI 1053715250
  NPD
• Premier Family Medical - City Center

  • Family Medicine Physician
  • Eagle Mountain, UT
  • NPI 1649160235
  NPD

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731110400000",
    "number": "1720776966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7059 W ADDISON VIEW LN",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840815983",
            "telephone_number": "801-413-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S 2000 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125880",
            "telephone_number": "801-413-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLEY",
        "first_name": "VICTOR",
        "middle_name": "MANUEL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-26",
        "last_updated": "2024-11-09",
        "certification_date": "2024-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11099798-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diogenes Toledo-Alcalde, RN
• Katie Ann Toledo
• Jeremiah Ezekiel Tolento
• Andrew Chase Tollefson, DPT, CSCS
• Alana Janel Tolley, MSW
• Sara Tollstrup, FNP-C
• Brian Dean Tolman, LMT
• Eric Tolman
• Izabella Blue Love Simone Tolman
• January Blue Tolman

• Family Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.