Keri Danielle Victory-McDaniel, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

223953 Issued in AR

Practice address

1815 Pleasant Grove Rd
Jonesboro, AR 72405-7870

Phone

(870) 933-6886

Fax

(870) 336-1339

NPI assigned

Aug 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Keri Danielle Victory Former name

Medicare fee-for-service enrollment

Enrolled in MS, AR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Breaking Chains Mental Health and Wellness, PLLCGroup PAC ID 3072033943, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Breaking Chains Mental Health and Wellness, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jonesboro, AR
  • NPI 1154143675
  Medicare reassignment Care Compare group NPD
• Families, Inc of Arkansas

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jonesboro, AR
  • NPI 1770535569
  Medicare reassignment NPD
• Renew Mental Health and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jonesboro, AR
  • NPI 1447817572
  Medicare reassignment NPD
• Region Seven Mental Health Intellectual Disabilities Comm

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Point, MS
  • NPI 1700894730
  Medicare reassignment NPD
• Families, Inc. of Arkansas

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Searcy, AR
  • NPI 1932281938
  NPD
• Renew Mental Health and Wellness, LLC

  • Specialist
  • Jonesboro, AR
  • NPI 1467134007
  NPD

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1376191502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724057870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-336-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724057870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-336-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORY-MCDANIEL",
        "first_name": "KERI",
        "middle_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2024-02-12",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "888661",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "223953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERI",
            "last_name": "VICTORY",
            "middle_name": "DANIELLE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Sarahjane Peralta Villarama, OTR
• Carshina Vincent, MCD CCC-SLP
• Joe W Vincent, PHARMACIST
• Shawn Vincent

• Psychiatric/Mental Health Nurse Practitioner in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.