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VICTORY CLINIC LLC
NPI 1104540079
Clinic/Center - Multi-Specialty in Junction City, KS

Active since October 03, 2022
715 SOUTHWIND DR, JUNCTION CITY, KS 66441(785) 209-3779(785) 209-3780 Get Directions Write a Review

NPPES record last updated: January 9, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 9, 2026, Feb 12, 2025, Feb 4, 2025 and 2 more (5 updates tracked since 2022).

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, as its authorized official.

NPPES Registry Identity

NPI1104540079
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameVICTORY CLINIC LLC
Location Address715 SOUTHWIND DRJunction City, KS 66441-9021
Mailing Address715 Southwind DrJunction City, KS 66441-9021 · (785) 209-3779 · Fax (785) 209-3780
Phone(785) 209-3779
Fax(785) 209-3780
Organization SubpartNo
Authorized OfficialKristie M ClarkOwner · (719) 698-7933
Enumeration DateOctober 3, 2022
Last NPPES UpdateJanuary 9, 20265 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2026
✔ NPI 1104540079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
715 SOUTHWIND DR, Junction City, KS 66441
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Secondary Practice Locations 4

Location 16510 S Academy Blvd Ste 110Colorado Springs, CO 80906-8691 · Phone (719) 698-7933 · Fax (719) 698-7929
Location 2842 N Main StLansing, KS 66043-1305 · Phone (913) 250-5155 · Fax (913) 250-5515
Location 3705 1st Ave Ste ADodge City, KS 67801-4437 · Phone (620) 471-3140 · Fax (620) 471-3141
Location 43905 Vanesta DrManhattan, KS 66503-2001 · Phone (785) 775-1867 · Fax (785) 775-1700

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas, Inc..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

6

Medicare 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)

Kristie Clark, M.D.
Pediatric Medicine
NPI 1558473884
715 SOUTHWIND DR
Junction City, KS 66441
(785) 209-3779
✔ PECOSSame address
Robert Clark, M.D.
Family Practice
NPI 1811903560
715 SOUTHWIND DR
Junction City, KS 66441
(785) 209-3779
✔ PECOS✔ Accepts MedicareSame address
Kimberly Patro, APRN
Nurse Practitioner
NPI 1912422080
715 SOUTHWIND DR
Junction City, KS 66441
(785) 209-3779
✔ PECOS✔ Accepts MedicareSame address
Selia Whitney, M.D.
Psychiatry
NPI 1275982266
715 SOUTHWIND DR
Junction City, KS 66441
(785) 220-9377
✔ PECOS✔ Accepts MedicareSame address
Brooke Thouvenot
Nurse Practitioner
NPI 1053876573
842 N MAIN ST
Lansing, KS 66043
(913) 250-5155
✔ PECOS✔ Accepts Medicare107 mi
James Clements, APRN
Nurse Practitioner
NPI 1427426360
705 1ST AVE STE A
Dodge City, KS 67801
(620) 471-3140
✔ PECOS✔ Accepts Medicare192 mi

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 January 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.