VICTORY MEDICAL CLINIC (NPI# 1609204759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609204759 |
| Entity Type | Organization |
| Organization Name | VICTORY MEDICAL CLINIC |
| Practice Address |
9970 Lake Forest Blvd Suite C New Orleans LA 70127-2609 |
| Mailing Address |
8636 Marks St New Orleans LA 70118-4628 |
| Practice Telephone | 5049572336 |
| Practice Fax Number | 5049428700 |
| Mailing Telephone | 5049572336 |
| Mailing Fax Number | 5049428701 |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |
| Authorized Official Name | DR. HERBERT PETER BURRELL (OWNER) |
| Authorized Official Telephone | 5049572336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
9970 LAKE FOREST BLVD SUITE C |
| City | NEW ORLEANS |
| State | LA |
| Zip Code | 70127-2609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134555790 | Renata Weatherspoon | Nurse Practitioner | 9970 Lake Forest Blvd, Suite A, New Orleans, LA 70127-2609 | 2013-09-15 |
| 1982218285 | Life Care Mental Health Services LLC | Community/Behavioral Health | 9970 Lake Forest Blvd, New Orleans, LA 70127-2609 | 2020-09-03 |
| 1720559743 | Community Choice Pharmacy LLC | Pharmacy | 9970 Lake Forest Blvd, New Orleans, LA 70127-2609 | 2018-12-17 |
| 1417424003 | Dana Ford Buggage | Pharmacist | 9970 Lake Forest Blvd, New Orleans, LA 70127-2609 | 2018-11-01 |
| 1780117648 | Terry Green | Case Manager/Care Coordinator | 9970 Lake Forest Blvd, New Orleans, LA 70127-2609 | 2017-04-07 |
| 1346773207 | Takira Morris | Counselor | 9970 Lake Forest Blvd, New Orleans, LA 70127-2609 | 2017-04-07 |
| 1194275420 | Kenneth Lawson | Counselor | 9970 Lake Forest Blvd, New Orleans, LA 70127-2609 | 2016-10-11 |
| 1629528963 | Ashley Hill | Counselor | 9970 Lake Forest Blvd, New Orleans, LA 70127-2609 | 2016-10-11 |
| 1841749637 | Kierra Andrews | Counselor | 9970 Lake Forest Blvd, New Orleans, LA 70127-2609 | 2016-09-22 |
| 1801349436 | Devin Bennett | Counselor | 9970 Lake Forest Blvd, New Orleans, LA 70127-2609 | 2016-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114567302 | Ruth Bermudez | Peer Specialist | 4747 Earhart Blvd Suite D, New Orleans, LA 70127 | 2020-01-15 |
| 1457830036 | Generations Health Inc | Case Manager/Care Coordinator | 8000 Crowder Blvd Ste B, New Orleans, LA 70127 | 2018-08-14 |
| 1881189066 | Gwendolyn A Brown | Psychologist | 9840 Andover Dr, New Orleans, LA 70127 | 2018-06-29 |
| 1407349095 | Impressive Diagnostics | Pathology | 7011 Read Blvd Ste I, New Orleans, LA 70127 | 2018-06-08 |
| 1528555760 | Traveling Grace Transportation Service LLC | Military/U.S. Coast Guard Transport | 7520 Shubrick Street, New Orleans, LA 70127 | 2018-04-13 |
| 1417450420 | Shannon Louella Bullock | Counselor | 10711 Vienna St, New Orleans, LA 70127 | 2018-03-15 |
| 1942719026 | Brianna Truffa | Counselor | 10001 Lake Forest Blvd., Suite 302, New Orleans, LA 70127 | 2017-09-21 |
| 1609303338 | Briana Alphonse | Counselor | 7240 Crowder Boulevard, Suite 202, New Orleans, LA 70127 | 2017-05-12 |
| 1679006720 | Michele Torregano | Case Manager/Care Coordinator | 10110 Deerfield Dr, New Orleans, LA 70127 | 2017-04-05 |
| 1083152128 | Keisha Black | Counselor | 8470 Morrison Road, Suite A, New Orleans, LA 70127 | 2017-02-09 |
| Find all providers in zip 70127 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407398993 | Paula Bland Inc | Clinic/Center | 2758 Hudson Pl, New Orleans, LA 70131-3856 | 2016-11-15 |
| 1396115978 | Central City | Clinic/Center | 2426 Simon Bolivar Ave, New Orleans, LA 70113-2548 | 2015-09-25 |
| 1669719357 | Primary Care Partners, LLC | Clinic/Center | 3514 Gentilly Blvd, New Orleans, LA 70122-4908 | 2013-01-15 |
| 1508163411 | Medical Center of Gentilly | Clinic/Center | 7901 Downman Rd, New Orleans, LA 70126-1200 | 2011-02-13 |
| 1104136241 | Leading Edge Services International, Inc | Clinic/Center | 1501 Newton St, Suite C, New Orleans, LA 70114-2562 | 2010-10-07 |
| 1972739191 | Common Ground Health Clinic | Clinic/Center | 1400 Teche St, New Orleans, LA 70114-5843 | 2009-06-02 |
| 1194870782 | Comprehensive Medical Associates of New Orleans, LLC | Clinic/Center | 4001 Gen Degaulle Dr, Suite H, New Orleans, LA 70114-8220 | 2007-01-24 |
| 1326146499 | Crescent City Pediatrics, L.L.C. | Clinic/Center | 320 N Carrollton Ave, Suite 103, New Orleans, LA 70119-5144 | 2006-09-20 |
| 1972094266 | Louisiana Academic Health Network | Clinic/Center | 5552 Read Blvd, New Orleans, LA 70127 | 2018-05-23 |
| 1659886935 | Krewe of Kids, LLC | Clinic/Center | 6600 Franklin Ave Ste A2, New Orleans, LA 70122-5716 | 2017-12-07 |
| Find all providers in NEW ORLEANS | ||||
| City | NEW ORLEANS |
| Zip Code | 70127 |
Please comment or provide details below to improve the information on VICTORY MEDICAL CLINIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.