Victory Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

4182 Issued in OK

Legal business name

VICTORY HOSPICE, INC.

Doing business as

Victory Home Health and Hospice

Practice address

104 Thoma Dr Ste 1
Elgin, OK 73538-2203

Phone

(580) 492-6166

Fax

(580) 492-6160

NPI assigned

Jan 4, 2006

Last updated

Jun 17, 2015By 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

Kim Cripps, RN

Title

Administrator

Phone

(580) 371-2002

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Victory Home Health and Hospice Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• A Path of Care Hospice IV, LLC

  dba A Path of Care Hospice

  • Community Based Hospice Care Agency
  • Lawton, OK
  • NPI 1043905722

  Sold to, 2023-07-31

  CMS change of ownership

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1821076506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 769",
            "address_2": "104 THOMA SUITE 1",
            "city": "ELGIN",
            "state": "OK",
            "postal_code": "735380769",
            "telephone_number": "580-492-6166",
            "fax_number": "580-492-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 THOMA DR STE 1",
            "city": "ELGIN",
            "state": "OK",
            "postal_code": "735382203",
            "telephone_number": "580-492-6166",
            "fax_number": "580-492-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-04",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "CRIPPS",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "580-371-2002",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OK",
            "license": "4182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200010380B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victory Home Health and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacy a Dudark, LCSW, Inc
• Patricia Rae Thurman, LCSW
• Tunnel Vision Recovery LLC
• Valir Outpatient Clinic #7 LLC
• Victory Home Health, LLC (Victory Home Health and Hospice)
• Victory Medical Equipment
• Victory Medical Equipment LLC
• Victory Medical Equipment, LLC
• Shelby Leigh Zimmerman

• Community Based Hospice Care Agency in Elgin, OK
• Providers in Elgin, OK by specialty
• Community Based Hospice Care Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.