Individual provider Active NPI

Colleen Victory, MD

  • Emergency Medicine Physician
  • Cleveland, OH
National Provider Identifier
1033552724
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35069335 Issued in OH
Practice address
600 Superior Ave E
Suite 2400
Cleveland, OH 44114-2614
Phone
(216) 337-1622
NPI assigned
Apr 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35069335 OH Primary

Addresses

Primary practice location

600 Superior Ave E
Suite 2400
Cleveland, OH 44114-2614

Mailing address

600 Superior Ave E
Suite 2400
Cleveland, OH 44114-2614
Phone (216) 337-1622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
64310FLMDPharmacist
35069335OHMDEmergency Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1033552724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SUPERIOR AVE E",
            "address_2": "SUITE 2400",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142614",
            "telephone_number": "216-337-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SUPERIOR AVE E",
            "address_2": "SUITE 2400",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142614",
            "telephone_number": "216-337-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORY",
        "first_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35069335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.