Vicktoria Amme' Williams, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA30684 Issued in FL

Practice address

101 Eucalyptus Ave
Crescent City, FL 32112-2407

Phone

(386) 698-0841

NPI assigned

Nov 23, 2020

Last updated

Nov 23, 2020By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1912501636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 460",
            "city": "LAKE COMO",
            "state": "FL",
            "postal_code": "321570460",
            "telephone_number": "386-643-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 EUCALYPTUS AVE",
            "city": "CRESCENT CITY",
            "state": "FL",
            "postal_code": "321122407",
            "telephone_number": "386-698-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "VICKTORIA",
        "middle_name": "AMME'",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA30684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunrise Primary Care Inc
• T R Suggs MD Medical Clinic PA
• Mark Erik Tallaksen, D.C.
• The Pavilion at Crescent Lake for Nursing and Rehabilitation, LLC (The Pavilion at Crescent Lake)
• Erica Varesi, LPN

• Physical Therapy Assistant in Crescent City, FL
• Providers in Crescent City, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.