Organization Active NPI

Vibrant Life for Kansas LLC

  • Physical Medicine & Rehabilitation Physician
  • Wichita, KS
National Provider Identifier
1073050878
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
VIBRANT LIFE FOR KANSAS LLC
Practice address
4510 W Central Ave
Suite B
Wichita, KS 67212-2203
Phone
(316) 448-3578
Fax
(316) 448-7548
NPI assigned
Jan 31, 2017
Last updated
Jan 31, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Authorized official

Name
Todd Henry EckNPI 1508943804
Title
Owner
Phone
(316) 448-3578

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
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

4510 W Central Ave
Suite B
Wichita, KS 67212-2203

Mailing address

4510 W Central Ave
Suite B
Wichita, KS 67212-2203
Phone (316) 448-3578

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485820800000",
    "number": "1073050878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 W CENTRAL AVE",
            "address_2": "SUITE B",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672122203",
            "telephone_number": "316-448-3578",
            "fax_number": "316-448-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 W CENTRAL AVE",
            "address_2": "SUITE B",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672122203",
            "telephone_number": "316-448-3578",
            "fax_number": "316-448-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT LIFE FOR KANSAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-31",
        "last_updated": "2017-01-31",
        "status": "A",
        "authorized_official_last_name": "ECK",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-448-3578"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.