NPIMap

Individual provider Active NPI

Victoria A Damba, DO

  • Family Medicine Physician
  • Perryville, MO
National Provider Identifier
1326099607
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
113379 Issued in MO
Practice address
1508 Edgemont Blvd
Perryville, MO 63775-1231
Phone
(573) 768-3220
Fax
(573) 519-5330
NPI assigned
May 12, 2006
Last updated
Jan 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 113379 MO Primary

Addresses

Primary practice location

1508 Edgemont Blvd
Perryville, MO 63775-1231

Mailing address

1508 Edgemont Blvd
Perryville, MO 63775-1231
Phone (573) 768-3220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060707000304 MO Practitioner - Family Practice 7214952258 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital PerryGroup PAC ID 1153777826, 115 clinicians

Practice addresses (Care Compare)

1508 Edgemont Blvd
Primary Care/Convenient Care
Perryville, MO 63775-1231
Phone (573) 768-3220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
113379MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Perry Current Accepting new patients
Mercy East Ambulatory Services LLC CurrentSince Nov 1, 2020 Accepting new patients
Cole Physician Services LLC CurrentSince Dec 2, 2012 Accepting new patients
Mercy Hospital Perry Family Medicine CurrentSince Jan 20, 2025 Accepting new patients
Mercy Hospital Perry Family Medicine CurrentSince Jan 20, 2025 Accepting new patients
Farmington Clinic Company LLC Family Medicine Past Accepting new patients
Mineral Area Osteopathic Hospital Inc Family Medicine Past Accepting new patients
Community Health Care Associates, Inc Family Medicine Past Accepting new patients
Mercy Hospital Perry Family Medicine Past Accepting new patients
Community Health Care Associates, Inc Family Medicine Past Accepting new patients
Midwest Health Group Convenient Care, LLC Past Accepting new patients

Locations

660A S Truman Blvd
Festus, MO 63028
Phone (636) 931-3800

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

1508 Edgemont Blvd
Perryville, MO 63775
Phone (573) 339-2000

434 N West St
Perryville, MO 63775
Phone (573) 547-2530

11445 Olive Blvd
Saint Louis, MO 63141
Phone (314) 428-9543

555 Washington Sq
Washington, MO 63090
Phone (636) 390-1777

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

Organizations & group practices 12

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

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1326099607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 EDGEMONT BLVD",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751231",
            "telephone_number": "573-768-3220",
            "fax_number": "573-519-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 EDGEMONT BLVD",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751231",
            "telephone_number": "573-768-3220",
            "fax_number": "573-519-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMBA",
        "first_name": "VICTORIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "113379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perryville, MO

Sources for this page

Verify at the official NPI Registry.