Vitality DX LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

VITALITY DX LLC

Doing business as

Sphere DX

Practice address

2277 Thunderstick Dr Ste 200
Lexington, KY 40505-4882

Phone

(502) 830-9503

NPI assigned

Nov 10, 2020

Organization subpart

No

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

Authorized official

Name

Tamia Fisher

Title

Credentialing

Phone

(812) 962-7894

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Sphere DX Doing business as

Locations

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1386246858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7145 E VIRGINIA ST STE 2000",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477159147",
            "telephone_number": "812-962-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 THUNDERSTICK DR STE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405054882",
            "telephone_number": "502-830-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY DX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-10",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "TAMIA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "812-962-7894"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100719120",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "18D2200531",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sphere DX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Lexington, KY
• Providers in Lexington, KY by specialty
• Clinical Medical Laboratory in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.