NPIMap

Organization Active NPI

Vitality Corporation

Doing business as Renaissance Family Chiropractic

  • Chiropractor
  • Everett, WA
National Provider Identifier
1770148363
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
VITALITY CORPORATION
Doing business as
Renaissance Family Chiropractic
Practice address
2824 Grand Ave Ste 102
Everett, WA 98201-3482
Phone
(425) 257-0177
NPI assigned
May 8, 2019
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Rhea Bucasas, D.C.
Title
Owner
Phone
(425) 257-0177

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Massage Therapist 225700000X NU

Addresses

Primary practice location

2824 Grand Ave Ste 102
Everett, WA 98201-3482

Mailing address

2824 Grand Ave Ste 102
Everett, WA 98201-3482
Phone (425) 257-0177

Other identifiers 1

IdentifierTypeStateIssuer
G8935706MedicaidWA

Other names 1

  • Renaissance Family Chiropractic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1557273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1770148363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 GRAND AVE STE 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013482",
            "telephone_number": "425-257-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 GRAND AVE STE 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013482",
            "telephone_number": "425-257-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-08",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "BUCASAS",
        "authorized_official_first_name": "RHEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-257-0177",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G8935706",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renaissance Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.