NPIMap

Organization Active NPI

Vitality Pain Relief LLC

Doing business as Vitality Healing Center

  • Physical Medicine & Rehabilitation Physician
  • Overland Park, KS
National Provider Identifier
1689322513
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
VITALITY PAIN RELIEF LLC
Doing business as
Vitality Healing Center
Practice address
14876 Metcalf Ave
Overland Park, KS 66223-2206
Phone
(913) 956-9370
NPI assigned
Mar 10, 2022
Last updated
Oct 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Authorized official

Name
Robyn DesautelNPI 1215100870
Title
Authorized Official
Phone
(913) 956-9370

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

14876 Metcalf Ave
Overland Park, KS 66223-2206

Mailing address

14876 Metcalf Ave
Overland Park, KS 66223-2206
Phone (913) 956-9370

Other names 1

  • Vitality Healing Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220729000318 KS Part B Supplier - Clinic/Group Practice 4385026913 Receives reassigned benefits from 5 practitioners
Practice locations: Overland Park, KS
O20221003000774 KS DME Supplier - Nurse Practitioner 4385026913 Practice locations: Overland Park, KS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Vitality Pain Relief14876 Metcalf Ave, Overland Park, KS 66223-2206(806) 543-1206 Negative Pressure Wound Therapy Pumps/Supplies|Canes and/or Crutches|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Surgical Dressings Accepts assignmentParticipating since May 1, 2022

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1646870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1689322513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14876 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662232206",
            "telephone_number": "913-956-9370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14876 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662232206",
            "telephone_number": "913-956-9370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY PAIN RELIEF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "DESAUTEL",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "913-956-9370"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitality Healing Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vitality Healing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.