VICTORY WELLNESS CENTER, LLC (NPI# 1255662516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255662516 |
| Entity Type | Organization |
| Organization Name | VICTORY WELLNESS CENTER, LLC |
| Other Organization Name | VICTORY WELLNESS CENTER, LLC |
| Practice Address |
123 Caillavet St Biloxi MS 39530-4101 |
| Mailing Address |
Po Box 8556 Biloxi MS 39535-8556 |
| Practice Telephone | 2283867487 |
| Practice Fax Number | 2283867499 |
| Mailing Telephone | 2516102644 |
| Mailing Fax Number | 2516399707 |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2010-01-26 |
| Authorized Official Name | SUPORIOR R HARRIS (C.E.O./ CERTIFIED NURSE PRACTITIONE) |
| Authorized Official Telephone | 2516102644 |
| Authorized Official Credential | CRNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | R866985 | MS | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| VICTORY WELLNESS CENTER, LLC | Other Name - Individual/Organization |
| Street Address |
123 CAILLAVET ST |
| City | BILOXI |
| State | MS |
| Zip Code | 39530-4101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982034351 | Medical Analysis LLC | Clinic/Center | 123 Caillavet St, Biloxi, MS 39530-4101 | 2013-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588158125 | Gulf Coast Anesthesia Associates | Anesthesiology | 147 Reynoir St Ste 305, Biloxi, MS 39530 | 2018-06-18 |
| 1326486804 | Pavilion Personal Care LLC | In Home Supportive Care | 1450b Beach Blvd, Biloxi, MS 39530 | 2013-06-06 |
| 1366707713 | Makeva K Reed | Nurse Practitioner | 321 Division St, Biloxi, MS 39530 | 2012-07-11 |
| 1174833602 | Keith Edward Earley Jr. | Ophthalmology | 301 Fisher Ave, Keesler Afb, MS 39530 | 2010-10-18 |
| 1730406729 | Alexander H. Nguyen | Surgery | 4503 M St, Biloxi, MS 39530 | 2010-04-29 |
| 1881891265 | Tina Fleming Mcgrew | Nurse Practitioner | 321-b Divison Street, Biloxi, MS 39530 | 2007-06-29 |
| 1285857623 | South Mississippi Nephrology, Pllc | Internal Medicine | 784 Vieux Marche, Biloxi, MS 39530 | 2007-04-11 |
| 1164573515 | Keith G Goodfellow | Obstetrics & Gynecology | 147 Reynoir St Ste 105, Biloxi, MS 39530 | 2007-01-14 |
| 1871640292 | Doreen Brock | Nurse Practitioner | 1046 Division Street, Biloxi, MS 39530 | 2007-01-05 |
| 1922069715 | Garvin Wallace Cunningham | Dentist | 683 Division St, Biloxi, MS 39530 | 2006-03-31 |
| Find all providers in zip 39530 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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|---|---|---|---|---|
| 1760080337 | Traditions Hospice of Biloxi, LLC | Clinic/Center | 243 Beauvoir Rd Ste B, Biloxi, MS 39531-4008 | 2020-10-15 |
| 1689088585 | Medical Solutions of Ocean Springs | Clinic/Center | 979 Tommy Munro Dr, Biloxi, MS 39532-2133 | 2014-06-18 |
| 1093964124 | Long Chiropractic, P. A. | Clinic/Center | 2541 Pass Rd, Ste H, Biloxi, MS 39531-2106 | 2008-09-12 |
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|---|---|---|---|---|
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| 1124644968 | First Choice Family Medical Clinic, LLC | Clinic/Center | 50 Highway 388, Brooksville, MS 39739 | 2020-06-17 |
| 1104447507 | Grace & Mercy Healthcare Center | Clinic/Center | 131 Lexington St, Pickens, MS 39146-3914 | 2020-04-27 |
| 1437788908 | Wellness Center | Clinic/Center | 1727 6th St, Meridian, MS 39301-5249 | 2020-04-06 |
| 1669018008 | Maximum Care After Hours Clinic, LLC | Clinic/Center | 212 Highway 61, Shaw, MS 38773-3877 | 2019-11-20 |
| 1598316895 | Florence Health Complex, LLC | Clinic/Center | 130 S Church St, Florence, MS 39073-8478 | 2019-09-27 |
| 1972150084 | Wound Management Specialists, LLC | Clinic/Center | 1190 N State St Ste 2a, Jackson, MS 39202-2413 | 2019-08-22 |
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| 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.