Individual provider Active NPI

Ann Elisabeth Victory, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1265689871
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301092519 Issued in MI
Practice address
200 Jefferson SE
Grand Rapids, MI 49503
Phone
(616) 685-5039
Fax
(616) 685-8910
NPI assigned
Aug 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301092519 MI Primary

Addresses

Primary practice location

200 Jefferson SE
Grand Rapids, MI 49503

Mailing address

245 State St SE
Ste 228
Grand Rapids, MI 49503
Phone (616) 685-1808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110902000487 MI Practitioner - HospitalistPractitioner - Internal Medicine 6507036357 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Michigan State University College of Human Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Hospital GroupGroup PAC ID 2365968351, 366 clinicians

Practice addresses (Care Compare)

1221 S Dr
Mt Pleasant, MI 48858-3257
Phone (989) 772-6700

Hospital & facility affiliations

  • McLaren Central Michigan Hospital, Mount Pleasant, MI, CCN 230080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301092519MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Hospital Group CurrentSince Jan 1, 2026 Accepting new patients
McLaren Central Michigan CurrentSince Nov 14, 2022 Accepting new patients
McLaren Central Michigan Current Accepting new patients
McLaren Central Michigan CurrentSince Nov 14, 2022 Accepting new patients
Physician Coverage Services PC Internal Medicine CurrentSince Oct 1, 2021 Accepting new patients
Trinity Health - Michigan Past Accepting new patients
Saint Mary'S Health Services Past Accepting new patients

Locations

1125 S Linden Rd
Ste 900
Flint, MI 48532
Phone (810) 733-5390

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

2700 Robert T Longway Blvd
Ste B
Flint, MI 48503
Phone (810) 235-2004

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

Interoperability endpoints

  • Direct secure messaging: avictory7150@epic00.shdirect.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1265689871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 STATE ST SE",
            "address_2": "STE 228",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-685-1808",
            "fax_number": "616-685-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-685-5039",
            "fax_number": "616-685-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORY",
        "first_name": "ANN",
        "middle_name": "ELISABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301092519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.