NPIMap

Organization Active NPI

Vitality Spine & Sports Physical Therapy, LLC

  • Physical Therapist
  • Sahuarita, AZ
National Provider Identifier
1740514629
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4064 Issued in AZ
Legal business name
VITALITY SPINE & SPORTS PHYSICAL THERAPY, LLC
Doing business as
Vitality Spine & Sports Physical Therapy, LLC
Practice address
15920 S Rancho Sahuarita Blvd
Suite 160
Sahuarita, AZ 85629-8012
Phone
(520) 867-8064
Fax
(520) 867-8063
NPI assigned
Sep 25, 2009
Last updated
Jun 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Authorized official

Name
Mr. Stephen C Hinkle, PTNPI 1750489217
Title
Owner
Phone
(520) 867-8064

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 Therapist 225100000X 4064 AZ Primary

Addresses

Primary practice location

15920 S Rancho Sahuarita Blvd
Suite 160
Sahuarita, AZ 85629-8012

Mailing address

15920 S Rancho Sahuarita Blvd Ste 160
Sahuarita, AZ 85629-8014
Phone (520) 867-8064

Other names 1

  • Vitality Spine & Sports Physical Therapy, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100311000851 AZ Part B Supplier - Clinic/Group Practice 9537294855 Receives reassigned benefits from 1 practitioner
Practice locations: Sahuarita, AZ

National Provider Directory

National Provider Directory

Locations

15920 S Rancho Sahuarita Blvd
Ste 160
Sahuarita, AZ 85629
Phone (520) 867-8064

Practitioners & affiliated clinicians

Practitioners 4

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": "1253836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1740514629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15920 S RANCHO SAHUARITA BLVD STE 160",
            "city": "SAHUARITA",
            "state": "AZ",
            "postal_code": "856298014",
            "telephone_number": "520-867-8064",
            "fax_number": "520-867-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15920 S RANCHO SAHUARITA BLVD",
            "address_2": "SUITE 160",
            "city": "SAHUARITA",
            "state": "AZ",
            "postal_code": "856298012",
            "telephone_number": "520-867-8064",
            "fax_number": "520-867-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY SPINE & SPORTS PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-25",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "HINKLE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-867-8064",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "4064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitality Spine & Sports Physical Therapy, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sahuarita, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.