Vitality Medical LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

VITALITY MEDICAL LLC

Doing business as

Vitality Medical

Practice address

110 Holt Dr
Madison, IN 47250-3873

Phone

(812) 265-6141

NPI assigned

Jul 16, 2022

Organization subpart

No

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

Authorized official

Name

Joshua Bronson

Title

Owner

Phone

(616) 204-0074

Specialties & licenses 1

Addresses

Other names 1

• Vitality Medical Doing business as

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

{
    "created_epoch": "1657929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657929600000",
    "number": "1447984265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HOLT DR",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472503873",
            "telephone_number": "812-265-6141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HOLT DR",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472503873",
            "telephone_number": "812-265-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-16",
        "last_updated": "2022-07-16",
        "certification_date": "2022-07-16",
        "status": "A",
        "authorized_official_last_name": "BRONSON",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-204-0074"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitality Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Madison, IN
• Providers in Madison, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.