Vitality Slim Clinic Limited Liability Company

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

VITALITY SLIM CLINIC LIMITED LIABILITY COMPANY

Practice address

10229 N Scottsdale Rd Ste B
Scottsdale, AZ 85253-1437

Phone

(855) 475-4636

NPI assigned

Jun 27, 2024

Organization subpart

No

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

Authorized official

Name

Fred Auzenne

Title

Manager

Phone

(480) 544-4467

Specialties & licenses 1

Addresses

Other names 1

• Vitality Slim Clinic LLC Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1144065491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10115 E BELL RD STE 107",
            "address_2": "#504",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602189",
            "telephone_number": "855-475-4636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10229 N SCOTTSDALE RD STE B",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852531437",
            "telephone_number": "855-475-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY SLIM CLINIC LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "AUZENNE",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-544-4467"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitality Slim Clinic LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vitality Slim Clinic LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.