NPIMap

Organization Active NPI

Vitality Acupuncture LLC

  • Acupuncturist
  • Meridian, ID
National Provider Identifier
1205337656
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
ACU279
Legal business name
VITALITY ACUPUNCTURE LLC
Practice address
1500 W Barrett Dr
Meridian, ID 83642-3728
Phone
(208) 629-4920
Fax
(888) 361-5391
NPI assigned
Feb 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Authorized official

Name
Heather Ann Bergstrom, LACNPI 1205166527
Title
Owner
Phone
(208) 629-4920

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X ACU279 Primary

Addresses

Primary practice location

1500 W Barrett Dr
Meridian, ID 83642-3728

Mailing address

1500 W Barrett Dr
Meridian, ID 83642-3728
Phone (208) 629-4920

National Provider Directory

National Provider Directory

Locations

1500 W Barrett Dr
Meridian, ID 83642
Phone (208) 629-4920

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519171200000",
    "number": "1205337656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W BARRETT DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423728",
            "telephone_number": "208-629-4920",
            "fax_number": "888-361-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W BARRETT DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423728",
            "telephone_number": "208-629-4920",
            "fax_number": "888-361-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-21",
        "last_updated": "2018-02-21",
        "status": "A",
        "authorized_official_last_name": "BERGSTROM",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-629-4920",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": "ACU279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.