Vista Wellness

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

VISTA WELLNESS

Practice address

1829 Reisterstown Rd Ste 350
Pikesville, MD 21208-7126

Phone

(443) 506-0709

Fax

(866) 285-9126

NPI assigned

Jul 31, 2019

Organization subpart

No

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

Authorized official

Name

Mr. David Pridgen

Title

President and Ceo

Phone

(443) 506-0709

Specialties & licenses 1

Addresses

Tax ID family

Vista Wellness2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vista Wellness

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Pikesville, MD
  • NPI 1427604057
  NPD tax ID

Locations

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565308800000",
    "number": "1528612215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 REISTERSTOWN RD STE 350",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212087126",
            "telephone_number": "443-506-0709",
            "fax_number": "866-285-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 REISTERSTOWN RD STE 350",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212087126",
            "telephone_number": "443-506-0709",
            "fax_number": "866-285-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-08-09",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "443-506-0709",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Village OB GYN Associates, LLC
• Village OB/GYN,LLC
• Leigh Vinocur, MD
• Natasha Virgil
• Vista Wellness
• Vital Care Pharmacy Inc
• Vitality 360 of Pikesville LLC
• Kairo Vivas, LCSW-C
• Elena Volkov, PA-C
• James Vornov, M.D., PH.D.

• Community/Behavioral Health Agency in Pikesville, MD
• Providers in Pikesville, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.