NPIMap

Organization Active NPI

Victory Medical Clinic

  • Primary Care Clinic/Center
  • New Orleans, LA
National Provider Identifier
1609204759
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
VICTORY MEDICAL CLINIC
Practice address
9970 Lake Forest Blvd
Suite C
New Orleans, LA 70127-2609
Phone
(504) 957-2336
Fax
(504) 942-8700
NPI assigned
Oct 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Authorized official

Name
Dr. Herbert Peter BurrellNPI 1104156835
Title
Owner
Phone
(504) 957-2336

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

9970 Lake Forest Blvd
Suite C
New Orleans, LA 70127-2609

Mailing address

8636 Marks St
New Orleans, LA 70118-4628
Phone (504) 957-2336

National Provider Directory

National Provider Directory

Locations

9970 Lake Forest Blvd
#C
New Orleans, LA 70127
Phone (504) 957-2336

9970 Lake Forest Blvd
Ste C
New Orleans, LA 70127
Phone (504) 957-2336

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": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1609204759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8636 MARKS ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701184628",
            "telephone_number": "504-957-2336",
            "fax_number": "504-942-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9970 LAKE FOREST BLVD",
            "address_2": "SUITE C",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701272609",
            "telephone_number": "504-957-2336",
            "fax_number": "504-942-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "BURRELL",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-957-2336",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.