Vibrancy Vip Medclinic LLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

VIBRANCY VIP MEDCLINIC LLC

Practice address

4801 Alameda Blvd NE Ste a
Albuquerque, NM 87113-1532

Phone

(505) 309-3496

Fax

(505) 441-2736

NPI assigned

Aug 2, 2022

Organization subpart

No

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

Authorized official

Name

Sonja Mailman

Title

Clinic Manager

Phone

(505) 309-3496

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristina Hammer, PA

  • Physician Assistant
  • Albuquerque, NM
  • NPI 1730502162
  NPD (past)

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1184351926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 ALAMEDA BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131532",
            "telephone_number": "505-309-3496",
            "fax_number": "505-441-2736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 ALAMEDA BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131532",
            "telephone_number": "505-309-3496",
            "fax_number": "505-441-2736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANCY VIP MEDCLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A",
        "authorized_official_last_name": "MAILMAN",
        "authorized_official_first_name": "SONJA",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "505-309-3496"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vha
• Amy Vialpando, LMHC
• Christina Vialpando
• Carlo Viamonte, M.D.
• Vibe Treatment Center LLC
• Vibrant Pathways ABA NM LLC
• Vibrant Tranquility LLC
• Kevin Vicenti, MD
• Kyetiil Shantelle Vicenti
• Una Mary Vicenti, OT

• Medical Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Medical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.