NPIMap

Organization Active NPI

Victorious Wellness, PLLC

  • Primary Care Clinic/Center
  • Danville, VA
National Provider Identifier
1205589017
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
VICTORIOUS WELLNESS, PLLC
Practice address
104 Huntington PL
Danville, VA 24541-4512
Phone
(757) 729-7281
NPI assigned
Feb 1, 2022
Last updated
Feb 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Authorized official

Name
Monica Mamina Kelly-Coleman, FNPNPI 1558876706
Title
Owner
Phone
(757) 324-5985

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

104 Huntington PL
Danville, VA 24541-4512

Mailing address

104 Huntington PL
Danville, VA 24541-4512
Phone (757) 729-7281

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1205589017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 HUNTINGTON PL",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414512",
            "telephone_number": "757-729-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HUNTINGTON PL",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414512",
            "telephone_number": "757-729-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIOUS WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "KELLY-COLEMAN",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "MAMINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-324-5985",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.