Victory Treatment Program, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

VICTORY TREATMENT PROGRAM, LLC

Practice address

9051 Executive Park Dr Ste 202
Knoxville, TN 37923-4626

Phone

(865) 337-7812

Fax

(865) 240-3539

NPI assigned

Jan 23, 2019

Organization subpart

No

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

Authorized official

Name

Tracey R. Maltman, NP

Title

Owner

Phone

(865) 337-7812

Specialties & licenses 1

Addresses

Other names 1

• Maltman Medical Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Stacey Maltman, FNP-BC

  • Family Nurse Practitioner
  • Knoxville, TN
  • NPI 1043694029
  NPD (past)

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1508320623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9051 EXECUTIVE PARK DR STE 202",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234626",
            "telephone_number": "865-337-7812",
            "fax_number": "865-240-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9051 EXECUTIVE PARK DR STE 202",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234626",
            "telephone_number": "865-337-7812",
            "fax_number": "865-240-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY TREATMENT PROGRAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "MALTMAN",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-337-7812",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maltman Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marvin Haber Vickers Jr., M.D.
• Daniel Vickery, AGCNS-BC
• Victor Hubbell Williams LLC
• Victor Hubbell Williams PLLC
• Victory Orthotics & Prosthetics LLC
• Danielle Everett Videla, MS
• Ariel Vidlund
• Roger Gordon Vieth, MD
• View Associates
• Juan Villalba, BS

• Family Medicine Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.