Vitality Anti-Aging Center and Med Spa

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

VITALITY ANTI-AGING CENTER AND MED SPA

Practice address

74 8TH St SE
Suite 101
Hickory, NC 28602-1130

Phone

(828) 322-1498

Fax

(828) 322-2835

NPI assigned

Mar 25, 2007

Last updated

Nov 24, 2014By 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

Grace McLaurin, PANPI 1366441149

Title

Owner

Phone

(828) 322-1498

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Grace McLaurin, PA-C

  • Medical Physician Assistant
  • Hickory, NC
  • NPI 1366441149
  NPD (past) Authorized official
• Marcus Todd Hinceman, N.P.

  • Family Nurse Practitioner
  • Hickory, NC
  • NPI 1538243696
  NPD (past)

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1285751008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 8TH STREET SE",
            "address_2": "SUITE 101",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024942",
            "telephone_number": "828-322-1498",
            "fax_number": "828-322-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 8TH ST SE",
            "address_2": "SUITE 101",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286021130",
            "telephone_number": "828-322-1498",
            "fax_number": "828-322-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY ANTI-AGING CENTER AND MED SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "MCLAURIN",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-322-1498",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Viewmont Urology Clinic, PA
• Lizette Villacorte, MD
• Vinhart Associates LLC (Home Instead Senior Care)
• Vinhart Associates, LLC (Home Instead Senior Care)
• Vision First Optometry PLLC
• Joseph V Vogel, M.D.
• Jessie Vrooman
• Sarah D Vulpitta
• Constance Boulware Wachsmuth, LCSW
• James A Wachsmuth, LCMHC

• Medical Physician Assistant in Hickory, NC
• Providers in Hickory, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.