Jacquelin N Victory, RN

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

6646 Issued in NC

Practice address

2100 Stantonsburg Rd
Greenville, NC 27834-2818

Phone

(252) 847-4100

NPI assigned

Aug 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHS Anesthesia Services Group IncGroup PAC ID 5799007324, 742 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atrium Health Union Hospital, Monroe, NC, CCN 340130

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CHS Anesthesia Services Group Inc

  • Anesthesiology Physician
  • Charlotte, NC
  • NPI 1346649415
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Charlotte-Mecklenburg Hospital Authority

  • General Acute Care Hospital
  • Monroe, NC
  • NPI 1396790325
  Care Compare affiliation

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1073123790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 DOCTOR BLAIR RD",
            "city": "MARSHVILLE",
            "state": "NC",
            "postal_code": "281039706",
            "telephone_number": "704-201-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818",
            "telephone_number": "252-847-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORY",
        "first_name": "JACQUELIN",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "6646",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "262101",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vibrance Medical Spa & Wellness Center, PLLC
• Blair Willis Vick, MS, CCC-SLP
• Elnora Linda Vick
• Susan Burch Vick, PTA
• Virginia McRoy Vickery, M.S.
• Vidant Medical Group Affiliates LLC
• Vidant Medical Group LLC
• Vidant Medical Group LLC
• Vidant Radiation Oncology LLC
• Sean Carl Vidulich, DO

• Certified Registered Nurse Anesthetist in Greenville, NC
• Providers in Greenville, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.