Organization Active NPI

Vitality Chiropractic, P.C.

  • Chiropractor
  • Grand Blanc, MI
National Provider Identifier
1366706426
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009667 Issued in MI
Legal business name
VITALITY CHIROPRACTIC, P.C.
Practice address
857 Health Park Blvd
Grand Blanc, MI 48439-7383
Phone
(810) 344-9279
Fax
(810) 344-9470
NPI assigned
Jul 3, 2012
Last updated
Aug 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Dr. Andrea Towers Bondy, DCNPI 1558654566
Title
President
Phone
(810) 955-4750

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301009667 MI Primary

Addresses

Primary practice location

857 Health Park Blvd
Grand Blanc, MI 48439-7383

Mailing address

5524 S Saginaw Rd
Grand Blanc, MI 48507-4421
Phone (810) 344-9279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120829000182 MI Part B Supplier - Clinic/Group Practice 7517114432 Receives reassigned benefits from 4 practitioners
Practice locations: Grand Blanc, MI

National Provider Directory

National Provider Directory

Locations

857 Health Park Blvd
Grand Blanc, MI 48439
Phone (810) 344-9279

7487 N Clio Rd
Mount Morris, MI 48458
Phone (313) 687-6100

Practitioners & affiliated clinicians

Practitioners 4

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": "1341273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1366706426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5524 S SAGINAW RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "485074421",
            "telephone_number": "810-344-9279",
            "fax_number": "810-344-9470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 HEALTH PARK BLVD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397383",
            "telephone_number": "810-344-9279",
            "fax_number": "810-344-9470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-03",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "BONDY",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "TOWERS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-955-4750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.