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VICTORY HEALTH SOLUTION LLC
NPI 1912515305
Nurse Practitioner - Psychiatric/Mental Health in Mesa, AZ

Active since July 21, 2020
1136 E HARMONY AVE # 202B-2, MESA, AZ 85204(602) 502-4872(480) 210-3563 Get Directions Write a Review

NPPES record last updated: January 15, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 15, 2026, Dec 26, 2021, Jul 22, 2020 (3 updates tracked since 2020).

About Victory Health Solution Llc NPPES

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

VICTORY HEALTH SOLUTION LLC (NPI 1912515305) is a healthcare organization registered as a psychiatric/mental health in Mesa, Arizona and active in the NPI registry since July 2020. The organization lists Ibukun O Odutola, Owner, as its authorized official.

NPPES Registry Identity

NPI1912515305
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameVICTORY HEALTH SOLUTION LLC
Location Address1136 E HARMONY AVE # 202B-2Mesa, AZ 85204-5844
Mailing Address1136 E Harmony Ave # 202b-2Mesa, AZ 85204-5844 · Fax (480) 210-3563
Phone(602) 502-4872
Fax(480) 210-3563
Organization SubpartNo
Authorized OfficialIbukun O OdutolaOwner · (623) 321-0760
Enumeration DateJuly 21, 2020
Last NPPES UpdateJanuary 15, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 15, 2026
✔ NPI 1912515305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
1136 E HARMONY AVE # 202B-2, Mesa, AZ 85204
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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

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 Health Solution Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Victory Health Solution LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Ibukun Odutola
Nurse Practitioner
NPI 1801404074
3345 N WINDSONG DR
Prescott Valley, AZ 86314
(928) 445-5211
✔ PECOS✔ Accepts Medicare88 mi
Olufunmilayo Kwentua
Nurse Practitioner
NPI 1669167672
14219 CALICE ST
Gonzales, LA 70737
(225) 803-7593
✔ PECOS✔ Accepts Medicare1,243 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 Health Solution LLC's NPI number?

The NPI number for Victory Health Solution LLC is 1912515305. It was assigned to this organization in the NPPES registry on July 21, 2020.

Where is Victory Health Solution LLC located?

Victory Health Solution LLC is located at 1136 E Harmony Ave # 202b-2, Mesa, AZ 85204. The listed phone number is (602) 502-4872.

What is Victory Health Solution LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Victory Health Solution LLC enrolled in Medicare?

Yes. Victory Health Solution LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Victory Health Solution LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Victory Health Solution 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Victory Health Solution LLC was last updated on January 15, 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.