NPIMap

Organization Active NPI

Vanness Enterprises, LLC

Doing business as Wellness Restoration Centers

  • General Practice Physician
  • Colorado Springs, CO
National Provider Identifier
1508198565
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
32854 Issued in CO
Legal business name
VANNESS ENTERPRISES, LLC
Doing business as
Wellness Restoration Centers
Practice address
4740 Flintridge Dr Ste 101
Colorado Springs, CO 80918-4254
Phone
(719) 510-6313
Fax
(719) 358-7756
NPI assigned
Feb 2, 2010
Last updated
Jul 9, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
VAN NESS ENTREPRISES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Authorized official

Name
Randee P Van Ness, MSNPI 1629300611
Title
Ceo
Phone
(719) 651-5102

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Nutrition Education NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133NN1002X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 32854 CO Primary

Addresses

Primary practice location

4740 Flintridge Dr Ste 101
Colorado Springs, CO 80918-4254

Mailing address

4740 Flintridge Dr Ste 101
Colorado Springs, CO 80918-4254
Phone (719) 510-6313

Other names 1

  • Wellness Restoration Centers Doing business as

National Provider Directory

National Provider Directory
Part of
Vanness Enterprises LLC

Practitioners & affiliated clinicians

Practitioners 1

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": "1265068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1508198565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 FLINTRIDGE DR STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184254",
            "telephone_number": "719-510-6313",
            "fax_number": "719-358-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 FLINTRIDGE DR STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184254",
            "telephone_number": "719-510-6313",
            "fax_number": "719-358-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANNESS ENTERPRISES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VAN NESS ENTREPRISES, LLC",
        "enumeration_date": "2010-02-02",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "VAN NESS",
        "authorized_official_first_name": "RANDEE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "719-651-5102",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CO",
            "license": "32854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Restoration Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.