Lightyear Health Clinic Iowa, PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

LIGHTYEAR HEALTH CLINIC IOWA, PC

Practice address

400 E Court Ave Ste 110
Des Moines, IA 50309-2027

Phone

(888) 380-0988

Fax

(833) 992-2313

NPI assigned

Jun 21, 2023

Last updated

Jun 21, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vinod Mitta, MD

Title

Owner

Phone

(888) 380-0988

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1811672397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 BUSKIRK AVE STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945976900",
            "telephone_number": "888-380-0988",
            "fax_number": "727-594-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E COURT AVE STE 110",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503092027",
            "telephone_number": "888-380-0988",
            "fax_number": "833-992-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTYEAR HEALTH CLINIC IOWA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "MITTA",
        "authorized_official_first_name": "VINOD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-380-0988",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Physical Medicine & Rehabilitation Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.