Vital Life Brands

Primary specialty

Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X

Legal business name

VITAL LIFE BRANDS

Practice address

3355 S State St
South Salt Lake, UT 84115-4526

Phone

(801) 335-5843

Fax

(801) 335-5843

NPI assigned

Oct 31, 2024

Organization subpart

No

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

Authorized official

Name

Michael Debenham, OWNER

Title

Managing Member

Phone

(801) 703-5885

Specialties & licenses 1

Addresses

Other names 1

• Simply Wellness Doing business as

Locations

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1134941925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 S STATE ST",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841154526",
            "telephone_number": "801-335-5843",
            "fax_number": "801-335-5843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 S STATE ST",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841154526",
            "telephone_number": "801-335-5843",
            "fax_number": "801-335-5843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2435 W 450 S Ste 102",
            "address_purpose": "LOCATION",
            "city": "Pleasant Grove",
            "state": "UT",
            "postal_code": "840623163",
            "country_code": "US",
            "telephone_number": "801-396-0924",
            "fax_number": "801-335-5843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VITAL LIFE BRANDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "DEBENHAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "801-703-5885",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Simply Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alison Vagen
• Joyce Ann Vandergriff
• Brittny Vanderhoof, RN
• Kristin Veerman
• Karina Velarde
• Amy M. Wadsworth, MS
• Samuel Elias Wagner
• Anafernanda Walker, CSWI
• Kevynne Walker
• Zhan Wang

• Obesity and Weight Management Nutrition Registered Dietitian in South Salt Lake, UT
• Providers in South Salt Lake, UT by specialty
• Obesity and Weight Management Nutrition Registered Dietitian in Utah

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