NPIMap

Organization Active NPI

Victory Clinic LLC

  • Multi-Specialty Clinic/Center
  • Junction City, KS
National Provider Identifier
1104540079
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
VICTORY CLINIC LLC
Practice address
715 Southwind Dr
Junction City, KS 66441-9021
Phone
(785) 209-3779
Fax
(785) 209-3780
NPI assigned
Oct 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Authorized official

Name
Kristie M Clark, MDNPI 1558473884
Title
Owner
Phone
(719) 698-7933

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

715 Southwind Dr
Junction City, KS 66441-9021

Mailing address

715 Southwind Dr
Junction City, KS 66441-9021
Phone (785) 209-3779

Other practice location 1

6510 S Academy Blvd Ste 110
Colorado Springs, CO 80906-8691
Phone (719) 698-7933

Other practice location 2

842 N Main St
Lansing, KS 66043-1305
Phone (913) 250-5155

Other practice location 3

705 1st Ave Ste A
Dodge City, KS 67801-4437
Phone (620) 471-3140

Other practice location 4

3905 Vanesta Dr
Manhattan, KS 66503-2001
Phone (785) 775-1867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230201001812 KS Part B Supplier - Clinic/Group Practice 8729459607 Receives reassigned benefits from 7 practitioners
Practice locations: Junction City, KS; Dodge City, KS; Manhattan, KS; Lansing, KS

National Provider Directory

National Provider Directory

Locations

6510 S Academy Blvd
Ste 110
Colorado Springs, CO 80906
Phone (719) 698-7933

715 Southwind Dr
Junction City, KS 66441
Phone (785) 209-3779

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1104540079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 SOUTHWIND DR",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664419021",
            "telephone_number": "785-209-3779",
            "fax_number": "785-209-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 SOUTHWIND DR",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664419021",
            "telephone_number": "785-209-3779",
            "fax_number": "785-209-3780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6510 S Academy Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809068691",
            "country_code": "US",
            "telephone_number": "719-698-7933",
            "fax_number": "719-698-7929",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "842 N Main St",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "KS",
            "postal_code": "660431305",
            "country_code": "US",
            "telephone_number": "913-250-5155",
            "fax_number": "913-250-5515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "705 1st Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Dodge City",
            "state": "KS",
            "postal_code": "678014437",
            "country_code": "US",
            "telephone_number": "620-471-3140",
            "fax_number": "620-471-3141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3905 Vanesta Dr",
            "address_purpose": "LOCATION",
            "city": "Manhattan",
            "state": "KS",
            "postal_code": "665032001",
            "country_code": "US",
            "telephone_number": "785-775-1867",
            "fax_number": "785-775-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VICTORY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-03",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-698-7933",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Junction City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.