Primal Vitality Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PRIMAL VITALITY INC

Practice address

4940 Windy Hill Dr Ste a
Raleigh, NC 27609-5278

Phone

(984) 308-1234

NPI assigned

May 24, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Michael A Lonardo, BCDNM, TND, HMD

Title

President

Phone

(984) 308-1234

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1124868468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 WINDY HILL DR STE A",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095278",
            "telephone_number": "984-308-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 WINDY HILL DR STE A",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095278",
            "telephone_number": "984-308-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMAL VITALITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "LONARDO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "984-308-1234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BCDNM, TND, HMD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Priestap
• Lauren Annelise Prigge, MS, RD, LDN, NBC-HWC
• Primal Health Inc
• Primal Pediatrics Inc
• Primal Performance Inc
• Primary Source Group, PLLC
• Primasun Medical Group of California, P.C.
• Primasun Medical Group of North Carolina, P.C.
• Primasun Medical Group of Texas, P.a.
• Lauren Primato, LCAS - A

• Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.