NPIMap

Organization Active NPI

Vitality Weight Loss and Wellness Institute, PLLC

  • Primary Care Clinic/Center
  • Plano, TX
National Provider Identifier
1710347737
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
Q6034 Issued in TX
Legal business name
VITALITY WEIGHT LOSS AND WELLNESS INSTITUTE, PLLC
Practice address
6201 Dallas Parkway
Suite 210
Plano, TX 75093
Phone
(972) 597-1639
NPI assigned
Mar 3, 2016
Last updated
Mar 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Ruby J Shah, MDNPI 1003134974
Title
Member Manager
Phone
(951) 314-2930

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
Primary Care Clinic/Center 261QP2300X Q6034 TX Primary

Addresses

Primary practice location

6201 Dallas Parkway
Suite 210
Plano, TX 75093

Mailing address

5760 Legacy Dr
Ste B3-424
Plano, TX 75024-7102
Phone (951) 314-2930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160603000160 TX Part B Supplier - Clinic/Group Practice 0345530333 Receives reassigned benefits from 6 practitioners
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Locations

2633 Dallas Pkwy
Plano, TX 75093
Phone (940) 390-1894

2633 Dallas Pkwy
#203
Plano, TX 75093
Phone (972) 599-9631

8080 Independence Pkwy
Plano, TX 75025
Phone (972) 521-5797

8080 Independence Pkwy
Ste 230
Plano, TX 75025
Phone (214) 396-4950

Practitioners & affiliated clinicians

Practitioners 8

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": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1710347737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5760 LEGACY DR",
            "address_2": "STE B3-424",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247102",
            "telephone_number": "951-314-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 DALLAS PARKWAY",
            "address_2": "SUITE 210",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75093",
            "telephone_number": "972-597-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY WEIGHT LOSS AND WELLNESS INSTITUTE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "RUBY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "951-314-2930",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "Q6034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.