Organization Active NPI

Victory Institute for Weight Management

  • Obesity Medicine (Internal Medicine) Physician
  • Wyoming, MI
National Provider Identifier
1851544555
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X
Legal business name
VICTORY INSTITUTE FOR WEIGHT MANAGEMENT
Practice address
2093 Health Dr SW
Suite 302
Wyoming, MI 49519-9691
Phone
(616) 457-3600
Fax
(616) 284-5208
NPI assigned
Oct 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Authorized official

Name
Dr. Matthew S Blair, D. O.
Title
Member
Phone
(616) 457-3600

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Obesity Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RB0002X Primary

Addresses

Primary practice location

2093 Health Dr SW
Suite 302
Wyoming, MI 49519-9691

Mailing address

2093 Health Dr SW
Suite 302
Wyoming, MI 49519-9691
Phone (616) 457-3600

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1851544555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2093 HEALTH DR SW",
            "address_2": "SUITE 302",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199691",
            "telephone_number": "616-457-3600",
            "fax_number": "616-284-5208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2093 HEALTH DR SW",
            "address_2": "SUITE 302",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199691",
            "telephone_number": "616-457-3600",
            "fax_number": "616-284-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY INSTITUTE FOR WEIGHT MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "616-457-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. O."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.