Vitality Age Management

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

34480 Issued in AZ

Legal business name

VITALITY AGE MANAGEMENT

Doing business as

VITALITY INTERGRATIVE MEDICAL GROUP

Practice address

1845 W Orange Grove Rd
Suite 115
Tucson, AZ 85704-1134

Phone

(800) 300-8464

Fax

(966) 567-5331

NPI assigned

May 26, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Mahesh Tipirneni, M.

Title

Partner

Phone

(800) 300-8464

Specialties & licenses 1

Addresses

Other names 1

• VITALITY INTERGRATIVE MEDICAL GROUP Doing business as

Locations

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1609169465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6890 E SUNRISE DR",
            "address_2": "SUITE 120-266",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857500738",
            "telephone_number": "180-030-0846",
            "fax_number": "186-656-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 W ORANGE GROVE RD",
            "address_2": "SUITE 115",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857041134",
            "telephone_number": "800-300-8464",
            "fax_number": "966-567-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY AGE MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "TIPIRNENI",
        "authorized_official_first_name": "MAHESH",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "18003008464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "34480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VITALITY INTERGRATIVE MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Visual Eyes LLC
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• Vitalab Pharmacy Inc
• Vitality Chiropractic PLLC
• Vitality Medical Group, PLLC
• Vitamindrip-Tucson LLC
• Vitavia LLC
• Ilaria Vittoria de Martini, MD

• Internal Medicine Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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.