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JACK HENRY VICTORY
NPI 1821892142
Student in an Organized Health Care Education/Training Program in Durham, NC

Active since April 03, 2025PECOS Enrolled
2301 ERWIN RD, DURHAM, NC 27705(919) 684-8111 Get Directions Write a Review

NPPES record last updated: April 3, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jack Henry Victory NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK HENRY VICTORY (NPI 1821892142) is an individual student in an organized health care education/training program in Durham, North Carolina and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821892142
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACK HENRY VICTORY
Location Address2301 ERWIN RDDurham, NC 27705-4699
Mailing Address2301 Erwin RdDurham, NC 27705-4699 · (919) 684-8111
Phone(919) 684-8111
Sole ProprietorYes
Enumeration DateApril 3, 2025
NPPES CertifiedApril 3, 2025
✔ NPI 1821892142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2301 ERWIN RD, Durham, NC 27705
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Henry Victory is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HONGYUN JUNE ZHU M.D.
Radiology (Diagnostic Radiology)
2301 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111
WILBUR RIGEL DATTILO M.D.
Psychiatry & Neurology (Psychiatry)
2301 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111
DR. SHARON MCCARTNEY M.D.
Anesthesiology
2301 ERWIN RD
DURHAM, NC 27705
Durham County (919) 681-3811
DR. JOEL GARRY MORASH M.D.
Student in an Organized Health Care Education/Training Program
2301 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111
REBEKAH DOIRON
Nurse Practitioner (Family)
2301 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111
DR. YURIY ZEYLIKMAN M.D.
Psychiatry & Neurology (Neurology)
2301 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111
ELIZABETH HOPE WEISSLER
Surgery (Vascular Surgery)
2301 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111
DR. ANGEL GUERRERO MD
Emergency Medicine
2301 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111

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 Jack Victory's NPI number?

The NPI number for Jack Victory is 1821892142. It was assigned to this individual provider in the NPPES registry on April 3, 2025.

Where is Jack Victory located?

Jack Victory practices at 2301 Erwin Rd, Durham, NC 27705. The listed phone number is (919) 684-8111.

What is Jack Victory's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jack Victory enrolled in Medicare?

Yes. Jack Victory is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Victory was last updated on April 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.