Organization Active NPI

Victory Vision, PLLC

  • Optometrist
  • Johnson City, TN
National Provider Identifier
1487470928
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VICTORY VISION, PLLC
Practice address
620 Suncrest Dr Unit 20
Johnson City, TN 37615-3686
Phone
(423) 820-3139
Fax
(423) 370-1246
NPI assigned
Dec 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Authorized official

Name
Dr. Victoria Howard, ODNPI 1912566449
Title
President
Phone
(423) 912-7743

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

620 Suncrest Dr Unit 20
Johnson City, TN 37615-3686

Mailing address

PO Box 8131
Johnson City, TN 37615-0131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260108003692 TN Part B Supplier - Clinic/Group Practice 4082190053 Receives reassigned benefits from 1 practitioner
Practice locations: Johnson City, TN

National Provider Directory

National Provider Directory

Locations

620 Suncrest Dr
Unit 20
Johnson City, TN 37615
Phone (423) 820-3139

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753056000000",
    "number": "1487470928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8131",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376150131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SUNCREST DR UNIT 20",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376153686",
            "telephone_number": "423-820-3139",
            "fax_number": "423-370-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY VISION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-02",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-912-7743",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.