Organization Active NPI

Victorious Health Services

Doing business as A Victorious Home Care

  • In Home Supportive Care Agency
  • Charlotte, NC
National Provider Identifier
1578621264
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
VICTORIOUS HEALTH SERVICES
Doing business as
A Victorious Home Care
Practice address
2332 Beatties Ford Rd
Charlotte, NC 28216-4314
Phone
(704) 535-0995
Fax
(704) 536-4373
NPI assigned
Dec 5, 2006
Last updated
May 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Authorized official

Name
Cyprian Ike Ifedi
Title
Director / Administrator
Phone
(704) 535-0995

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Nursing Care Agency 251J00000X
Nursing Facility/Intermediate Care Facility 313M00000X HC2479 NC
Respite Care 385H00000X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

2332 Beatties Ford Rd
Charlotte, NC 28216-4314

Mailing address

2332 Beatties Ford Rd
Charlotte, NC 28216-4314
Phone (704) 535-0995

Other identifiers 3

IdentifierTypeStateIssuer
3409646MedicaidNC
7100596MedicaidNC
6601047MedicaidNC

Other names 1

  • A Victorious Home Care Doing business as

National Provider Directory

National Provider Directory

Locations

3549 N Sharon Amity Rd
Ste 300
Charlotte, NC 28205

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1578621264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2332 BEATTIES FORD RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282164314",
            "telephone_number": "704-535-0995",
            "fax_number": "704-536-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2332 BEATTIES FORD RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282164314",
            "telephone_number": "704-535-0995",
            "fax_number": "704-536-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIOUS HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "IFEDI",
        "authorized_official_first_name": "CYPRIAN",
        "authorized_official_middle_name": "IKE",
        "authorized_official_title_or_position": "DIRECTOR / ADMINISTRATOR",
        "authorized_official_telephone_number": "704-535-0995"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NC",
            "license": "HC2479",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409646",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100596",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601047",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Victorious Home Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "A Victorious Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.