Victory Vision PC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

GA 002439 Issued in GA

Legal business name

VICTORY VISION PC

Practice address

3507 Manchester Expy
Unit 92
Columbus, GA 31909-6400

Phone

(706) 327-0111

Fax

(706) 327-4980

NPI assigned

Jun 29, 2009

Last updated

Jul 15, 2010By 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

Dr. David Rossello, O.D.NPI 1558329771

Title

President

Phone

(215) 833-3465

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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.

• David A Rossello, O.D.

  • Optometrist
  • Columbus, GA
  • NPI 1558329771
  Medicare reassignment NPD Authorized official
• Kelly Honsinger Nilsson, OD

  • Optometrist
  • Columbus, GA
  • NPI 1598040354

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1386872331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 MANCHESTER EXPY",
            "address_2": "UNIT 92",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319096400",
            "telephone_number": "706-327-0111",
            "fax_number": "706-327-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 MANCHESTER EXPY",
            "address_2": "UNIT 92",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319096400",
            "telephone_number": "706-327-0111",
            "fax_number": "706-327-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY VISION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-29",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "ROSSELLO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-833-3465",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": "GA 002439",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "GA",
            "license": "GA 002439",
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "GA",
            "license": "GA 002439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daejah Vicente
• Donald Vickers, M.D.
• James E Vickers Jr., PA-C
• Chelsea Moore Vickery, FNP-C
• Victory Rehabilitation LLC
• Village Apothecary LLC (The Village Apothecary, LLC)
• Melanie Quiva Villarosa-Sojan, CRNA
• Timothy Paul Villegas, M.D.
• Vincent M. Nicolais, MD, PC
• Elijah Vincent, RBT

• Point of Service in Columbus, GA
• Providers in Columbus, GA by specialty
• Point of Service in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.