Vitality Health

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

VITALITY HEALTH

Practice address

10557 W Carlton Bay Dr Ste 106
Garden City, ID 83714-5200

Phone

(304) 617-1511

NPI assigned

Dec 13, 2023

Organization subpart

No

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

Authorized official

Name

Ashley W Bennett, MDNPI 1326252545

Title

Owner Provider

Phone

(304) 617-1511

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ashley W Bennett, MD

  • Surgery Physician
  • Boise, ID
  • NPI 1326252545
  NPD (past) Authorized official

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1043088628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10557 W CARLTON BAY DR STE 106",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837145200",
            "telephone_number": "304-617-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10557 W CARLTON BAY DR STE 106",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837145200",
            "telephone_number": "304-617-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER PROVIDER",
        "authorized_official_telephone_number": "304-617-1511",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Treasure Valley Vein and Wound Center LLC
• True Path Therapy LLC
• Trueform Health Solutions
• Yomirra Al Tussa
• Unicare Health Services of Idaho L.L.C.
• Sara Walton, N.M.D.
• Alexander Welch
• Bree Danielle Wells
• Jennifer Weseman, LCPC
• Lindsay Merle Westerman, APRN, CPNP-AC/PC

• Surgery Physician in Garden City, ID
• Providers in Garden City, ID by specialty
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.