Organization Active NPI

Vitality Health Center, LLC

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1144624776
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1812 Issued in NE
Legal business name
VITALITY HEALTH CENTER, LLC
Practice address
14471 W Center Rd
Omaha, NE 68144-5401
Phone
(402) 758-1088
Fax
(402) 758-1099
NPI assigned
Oct 10, 2014
Last updated
Oct 31, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Authorized official

Name
Kayla St. Aubin, D.C.
Title
Chiropractor/Owner
Phone
(402) 758-1088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1812 NE Primary

Addresses

Primary practice location

14471 W Center Rd
Omaha, NE 68144-5401

Mailing address

14471 W Center Rd
Omaha, NE 68144-5401
Phone (402) 758-1088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141015001073 NE Part B Supplier - Clinic/Group Practice 5294956355 Receives reassigned benefits from 1 practitioner
Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Locations

14208 Pierce Plz
Omaha, NE 68144
Phone (402) 637-3901

14471 W Center Rd
Omaha, NE 68144
Phone (402) 758-1088

Practitioners & affiliated clinicians

Practitioners 2

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": "1412899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572480000000",
    "number": "1144624776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14471 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445401",
            "telephone_number": "402-758-1088",
            "fax_number": "402-758-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14471 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445401",
            "telephone_number": "402-758-1088",
            "fax_number": "402-758-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY HEALTH CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-10",
        "last_updated": "2019-10-31",
        "status": "A",
        "authorized_official_last_name": "ST. AUBIN",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "402-758-1088",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.