NPIMap

Organization Active NPI

Lifevitality USA Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Richmond Heights, OH
National Provider Identifier
1811541469
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
LIFEVITALITY USA MEDICAL GROUP, LLC
Practice address
464 Richmond Rd Ste 202
Richmond Heights, OH 44143-2704
Phone
(330) 824-4200
Fax
(440) 525-5564
NPI assigned
Jul 31, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Authorized official

Name
Kelli BlackNPI 1104589878
Title
Billing Mananger
Phone
(216) 512-5929

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

464 Richmond Rd Ste 202
Richmond Heights, OH 44143-2704

Mailing address

464 Richmond Rd Ste 202
Richmond Heights, OH 44143-2704
Phone (330) 824-4200

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1564531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564531200000",
    "number": "1811541469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 RICHMOND RD STE 202",
            "city": "RICHMOND HEIGHTS",
            "state": "OH",
            "postal_code": "441432704",
            "telephone_number": "330-824-4200",
            "fax_number": "440-525-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 RICHMOND RD STE 202",
            "city": "RICHMOND HEIGHTS",
            "state": "OH",
            "postal_code": "441432704",
            "telephone_number": "330-824-4200",
            "fax_number": "440-525-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEVITALITY USA MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "BILLING MANANGER",
        "authorized_official_telephone_number": "216-512-5929"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.