Amazing Victory LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

AMAZING VICTORY LLC

Doing business as

Amazing Victory Health and Wellness LLC

Practice address

1201 Kings Hwy Ste 2
Fairfield, CT 06824-5319

Phone

(475) 500-2334

NPI assigned

Feb 14, 2023

Last updated

Feb 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Stephanie Larose, APRNNPI 1235647181

Title

Ceo

Phone

(475) 500-2334

Specialties & licenses 1

Addresses

Other names 1

• Amazing Victory Health and Wellness LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie Larose

  • Family Nurse Practitioner
  • Bridgeport, CT
  • NPI 1235647181
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1134826712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 KINGS HWY STE 2",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245319",
            "telephone_number": "475-500-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 KINGS HWY STE 2",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245319",
            "telephone_number": "475-500-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING VICTORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-05",
        "status": "A",
        "authorized_official_last_name": "LAROSE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "475-500-2334",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amazing Victory Health and Wellness LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Louis Alter
• Aimee S. Altschul-Latzman, M.D.
• Evan Alvarado, DPT
• Donna Alves, LCCC, LPC
• Alzheimer's and Dementia Care
• Nancy C Amberson, M.D.
• Kelms Amoo-Achampong, MD
• Brian Amoroso, D.D.S.
• Amy a Payson Edd CS Aprn BC LLC
• Rahul Singh Anand, M.D.

• Nurse Practitioner in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.