Vitality Group of Wny

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

21MA1407640 Issued in NY

Legal business name

VITALITY GROUP OF WNY

Doing business as

Massage Envy Spa

Practice address

3670 McKinley Pkwy
Massage Envy
Blasdell, NY 14219-2696

Phone

(716) 822-3689

NPI assigned

Nov 7, 2013

Last updated

Nov 7, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Fred Grant Morse III

Title

President

Phone

(239) 269-3279

Specialties & licenses 1

Addresses

Other names 1

• Massage Envy Spa Doing business as

Locations

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1154750321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 IMMOKALEE RD",
            "address_2": "#105",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101445",
            "telephone_number": "239-269-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 MCKINLEY PKWY",
            "address_2": "MASSAGE ENVY",
            "city": "BLASDELL",
            "state": "NY",
            "postal_code": "142192696",
            "telephone_number": "716-822-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY GROUP OF WNY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "MORSE",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-269-3279",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "21MA1407640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Massage Envy Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Massage Therapist in Blasdell, NY
• Providers in Blasdell, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.