Vital Yoga Therapeutics, LLC

Primary specialty

Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X

Legal business name

VITAL YOGA THERAPEUTICS, LLC

Practice address

2225 A1A S Ste B1
Saint Augustine, FL 32080-7906

Phone

(904) 874-5152

NPI assigned

Apr 10, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Liana Raschke Valla, OTR/L, IYTT, OMCNPI 1366967283

Title

Owner

Phone

(904) 874-5152

Specialties & licenses 1

Addresses

Other names 2

• Vital Therapy Doing business as
• VitalTherapy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Liana Raschke Valla

  • Gerontology Occupational Therapist
  • St Augustine, FL
  • NPI 1366967283
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586476800000",
    "number": "1376162289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 SAN JOSE FOREST DR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320805412",
            "telephone_number": "904-874-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 A1A S STE B1",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320807906",
            "telephone_number": "904-874-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL YOGA THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-10",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A",
        "authorized_official_last_name": "VALLA",
        "authorized_official_first_name": "LIANA",
        "authorized_official_middle_name": "RASCHKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-874-5152",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L, IYTT, OMC"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vital Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VitalTherapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vip Doctors Care of St Augustine LLC
• Vivian Page Virga, P.T.
• Daniel Jacob Vish, D.C.
• Vista Wellness, LLC
• Vital Care DME LLC
• James Alan Viti, PT
• Vitrectomy Recovery Equipment
• Vitrectomy Recovery Equipment
• Carmen C Vivero, M.D.
• Katherine Lorraine Vogel, RD

• Neurorehabilitation Occupational Therapist in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Neurorehabilitation Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; 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.