Organization Active NPI

Body Spirit & Soul Medical PLLC

  • Family Medicine Physician
  • Colleyville, TX
National Provider Identifier
1235909185
Registry record updated Jan 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BODY SPIRIT & SOUL MEDICAL PLLC
Practice address
7165 Colleyville Blvd Ste 102
Colleyville, TX 76034-8010
Phone
(972) 983-8915
Fax
(949) 695-3905
NPI assigned
Jan 2, 2024
Last updated
Jan 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2024

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

Authorized official

Name
Dr. Joseph B Ventimiglia, MD
Title
Physician / Owner
Phone
(972) 983-8915

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

7165 Colleyville Blvd Ste 102
Colleyville, TX 76034-8010

Mailing address

1611 Pheasant LN
Southlake, TX 76092-3436
Phone (972) 983-8915

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1704153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704585600000",
    "number": "1235909185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 PHEASANT LN",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760923436",
            "telephone_number": "972-983-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7165 COLLEYVILLE BLVD STE 102",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760348010",
            "telephone_number": "972-983-8915",
            "fax_number": "949-695-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY SPIRIT & SOUL MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-07",
        "certification_date": "2024-01-07",
        "status": "A",
        "authorized_official_last_name": "VENTIMIGLIA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICIAN / OWNER",
        "authorized_official_telephone_number": "972-983-8915",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colleyville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2024; 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.