VICTORY CLINICAL SERVICES II LLC
VICTORY CLINICAL SERVICES II LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1497798284, based in South Bend, IN. The organization lists 3 taxonomy classifications, with Addiction Medicine (Family Medicine) Physician recorded as primary.
Getting there
The practice address on file is 4218 W WESTERN AVE, South Bend, IN 46619. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 02001493A | IN | Addiction Medicine (Family Medicine)… primary |
| 20010221A | IN | Health Service Psychologist |
| 71001833A | IN | Nurse Practitioner |
This provider holds licence 02001493A issued in IN. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Part B Supplier - Opioid Treatment Program (otp)
- PAC ID
- 5193150274
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Opioid Treatment Program (otp). This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Addiction Medicine covers
A family medicine physician who specializes in the diagnosis and treatment of addictions. NUCC Health Care Provider Taxonomy, code 207QA0401X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207QA0401X | Addiction Medicine (Family Medicine) Physician Addiction Medicine | 02001493A | IN | primary |
| 103TH0100X | Health Service Psychologist Health Service | 20010221A | IN | |
| 363L00000X | Nurse Practitioner | 71001833A | IN |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1497798284 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Jun 13, 2006 |
| Last updated | Mar 22, 2012 |
| Status | Active |
| Practice address |
4218 W WESTERN AVE South Bend, IN 46619 (574) 233-1524 Fax (574) 233-1612 |
| Other identifiers |
1255432233
· WOODWARD NPC - NPI (IN) 168750 (IN) 100220790 (IN) 200495610 (IN) 1518055565 · SHEEHAN HSPP - NPI (IN) 1982647434 · WANG - NPI (IN) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 4 | 9 | 7 | 7 | 9 | 8 | 2 | 8 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 4 | 9 | 7 | 5 | 9 | 7 | 2 | 7 |
Sum = 76 · next multiple of 10 = 80 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.