Organization Active NPI

Vitality NP Group LLC

  • Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1083356307
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
VITALITY NP GROUP LLC
Practice address
511 Chantecler Ave Ste 1
Richmond, VA 23226-3000
Phone
(732) 486-7373
Fax
(732) 282-7200
NPI assigned
Apr 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Authorized official

Name
Ettie Tress
Title
Owner
Phone
(732) 486-7373

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X

Addresses

Primary practice location

511 Chantecler Ave Ste 1
Richmond, VA 23226-3000

Mailing address

685 River Ave Unit 3
Lakewood, NJ 08701-5288
Phone (732) 486-7373

National Provider Directory

National Provider Directory

Locations

456 Chestnut St
Unit 3
Lakewood, NJ 08701

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1083356307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 RIVER AVE UNIT 3",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015288",
            "telephone_number": "732-486-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 CHANTECLER AVE STE 1",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263000",
            "telephone_number": "732-486-7373",
            "fax_number": "732-282-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY NP GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-07",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "TRESS",
        "authorized_official_first_name": "ETTIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-486-7373"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.