Victor A Wilson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62232 Issued in OR

Practice address

735 SW 158TH Ave Ste 160
Beaverton, OR 97006-4952

Phone

(503) 597-0035

Fax

(503) 726-5490

NPI assigned

Jun 13, 2017

Last updated

Jun 13, 2017By the provider in NPPES

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 OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Edge Physical Therapy and Sports Medicine P.C.Group PAC ID 7113080714, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Active Edge Physical Therapy & Sports Medicine P.C.

  • Physical Therapy Clinic/Center
  • West Linn, OR
  • NPI 1730324336
  Medicare reassignment Care Compare group NPD
• Erhardt Physical Therapy and Sports Medicine, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Scappoose, OR
  • NPI 1326110313
  Medicare reassignment NPD
• Regenerative Orthopedic Center LLC

  • Orthopaedic Surgery Physician
  • Tualatin, OR
  • NPI 1568151561
  Medicare reassignment

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497312000000",
    "number": "1730619719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 SW 158TH AVE STE 160",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064952",
            "telephone_number": "503-597-0035",
            "fax_number": "503-726-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VICTOR",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2017-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Lee Wilson, RDH,BSDH
• Jennifer Michelle Wilson, PT, DPT
• Jessica L Wilson, DO
• Nicholas Ryan Wilson, LMT
• Stacey L Wilson, CNM
• Caelie Jaye Winchester
• Windrose Group Home LLC
• Lindsey Wineland
• Deborah Lee Winer, PH.D.
• Katherine Wing, LMT

• Physical Therapist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; 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.