Pure Victory, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2009032450 Issued in MO

Legal business name

PURE VICTORY, LLC

Doing business as

Victory Chiropractic

Practice address

800 State Hwy 248
Suite 2-B
Branson, MO 65616

Phone

(417) 337-7077

NPI assigned

Mar 15, 2010

Last updated

Jul 24, 2012By 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. Boaz L Bandy, DCNPI 1265755227

Title

Doctor of Chiropractic

Phone

(417) 337-7077

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Victory Chiropractic Doing business as

Locations

Practitioners 3

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.

• Boaz Lee Bandy, D.C.

  • Chiropractor
  • Branson, MO
  • NPI 1265755227
  NPD (past) Authorized official
• Nathan L Berbereia, D.C.

  • Chiropractor
  • Branson, MO
  • NPI 1194983023
  NPD (past)
• Jerod M Hill, D.C.

  • Chiropractor
  • Branson, MO
  • NPI 1720111032
  NPD (past)

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1730403106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 STATE HWY 248",
            "address_2": "SUITE 2-B",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "65616",
            "telephone_number": "417-337-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 STATE HWY 248",
            "address_2": "SUITE 2-B",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "65616",
            "telephone_number": "417-337-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE VICTORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "BANDY",
        "authorized_official_first_name": "BOAZ",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "417-337-7077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2009032450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE I",
            "identifier": "1265755227",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victory Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tarna Katricia Potter, PLPC
• Meagan Powers, DNAP-CRNA
• Anju Susan Prasad, M.D.
• Premier Family Medicine
• Abigail Leigh Pryor, MS, CCC-SLP
• Kathleen Dian Purvis, APRN, FNP
• Suzanne Newell Quigg, D.D.S.
• Saima Rehman Qureshi
• R & J Chiropractic, Inc. (A Family's Place - Rayle Family Wellness Chiropractic)
• Chelsea Lea Rainey, MSW, LCSW

• Chiropractor in Branson, MO
• Providers in Branson, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.