Desirae Renee Vigil, A.P

Primary specialty

SpecialistTaxonomy code 174400000X

License

COZ720555 Issued in CO

Practice address

12840 Holly St Unit 120
Thornton, CO 80602-8289

Phone

(720) 232-7135

NPI assigned

Jul 11, 2022

Last updated

Jul 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kidzone Therapy Center

  dba KidZone Therapy

  • Multi-Specialty Clinic/Center
  • Denver, CO
  • NPI 1245992874
  NPD Authorized official

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1407580095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12840 HOLLY ST UNIT 120",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "806028289",
            "telephone_number": "720-232-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12840 HOLLY ST UNIT 120",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "806028289",
            "telephone_number": "720-232-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGIL",
        "first_name": "DESIRAE",
        "middle_name": "RENEE",
        "credential": "A.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "COZ720555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORA",
            "identifier": "COZ720555",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vibra Hospital of Denver LLC (Vibra Hospital of Denver)
• Vibra Hospital of Denver LLC
• Vida Plena Wellness
• Philip Vidal
• Carol Vidaurre
• Shirley Ann Vigil, CACIII
• Anjana Vijayakumar
• Mechelle D. Viola-Lewis, M.D.
• Visiting Ancillary Services, Inc
• Visiting Ancillary Services, Inc

• Specialist in Thornton, CO
• Providers in Thornton, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.