VICTORY CLINIC LLC
NPI 1104540079
Clinic/Center - Multi-Specialty in Junction City, KS
About Victory Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VICTORY CLINIC LLC (NPI 1104540079) is a healthcare organization registered as a multi-specialty in Junction City, Kansas and active in the NPI registry since October 2022. The organization maintains 4 additional practice locations and lists Kristie M Clark, Owner And Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Secondary Practice Locations 4
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Victory Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Victory Clinic LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Victory Clinic LLC's NPI number?
The NPI number for Victory Clinic LLC is 1104540079. It was assigned to this organization in the NPPES registry on October 3, 2022.
Where is Victory Clinic LLC located?
Victory Clinic LLC is located at 715 Southwind Dr, Junction City, KS 66441. The listed phone number is (785) 209-3779.
What is Victory Clinic LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Victory Clinic LLC enrolled in Medicare?
Yes. Victory Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Victory Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 4 Medicare specialties reassign their Medicare billing to Victory Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3), Family Practice (1) and Pediatric Medicine (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Victory Clinic LLC accept?
Health plans from Blue Cross and Blue Shield of Kansas, Inc. list Victory Clinic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Victory Clinic LLC was last updated on October 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Victory Clinic Llc · NPI 1104540079
Multi-Specialty organization in Junction City, Kansas. Organization record, active in the CMS NPPES registry since October 3, 2022.
## Identity
- **NPI:** 1104540079 (Entity type: Organization)
- **Enumerated:** October 3, 2022
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Kristie Clark, OWNER AND CEO
## Practice location
- **Address:** 715 SOUTHWIND DR, Junction City, KS 66441-9021
- **Phone:** (785) 209-3779 · **Fax:** (877) 808-1658
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Family Practice (1), Pediatric Medicine (1); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 28, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1104540079) · Data from the CMS NPPES public registry.