Organization Active NPI

Change Center for Vitality

  • Family Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1720390362
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
CHANGE CENTER FOR VITALITY
Practice address
400 W Capitol Ave
Ste 100D
Little Rock, AR 72201-3436
Phone
(501) 324-2649
NPI assigned
Jul 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Authorized official

Name
Debra Velez
Title
President
Phone
(501) 324-8649

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

400 W Capitol Ave
Ste 100D
Little Rock, AR 72201-3436

Mailing address

400 W Capitol Ave
Ste 100D
Little Rock, AR 72201-3436
Phone (501) 324-2649

National Provider Directory

National Provider Directory

Locations

400 W Capitol Ave
Ste 100D
Little Rock, AR 72201
Phone (501) 324-2643

NPI Registry JSON

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278892800000",
    "number": "1720390362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W CAPITOL AVE",
            "address_2": "STE 100D",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722013436",
            "telephone_number": "501-324-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W CAPITOL AVE",
            "address_2": "STE 100D",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722013436",
            "telephone_number": "501-324-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE CENTER FOR VITALITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-12",
        "last_updated": "2010-07-12",
        "status": "A",
        "authorized_official_last_name": "VELEZ",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-324-8649"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.