Anthony James Videckis

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3800 Reservoir Rd NW
Washington, DC 20007-2113

Phone

(630) 675-1070

NPI assigned

Feb 27, 2023

Sex

Male

Sole proprietor

Yes

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 OH

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1871292169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3661 WINFIELD LN NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072350",
            "telephone_number": "630-675-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "630-675-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDECKIS",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victory Medical Supplies LLC
• Vidacare LLC
• Savanna I Vidal
• Timothy Vidale, D.P.T.
• Atiba Vheir Vidato, LPC
• Josephine Vidic
• Lindsie Dawn Viehdorfer, NP-C
• Vigeo Therapy LLC
• Frances Vignier
• Vigorito Counseling and Consulting

• Student in an Organized Health Care Education/Training Program in Washington, DC
• Providers in Washington, DC by specialty
• Student in an Organized Health Care Education/Training Program in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.