Active NPI
Victory Institute for Weight Management
- Obesity Medicine (Internal Medicine) Physician
- Wyoming, MI
National Provider Identifier
1851544555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obesity Medicine (Internal Medicine) Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Registered Dietitian | 133V00000X | |||
| Obesity Medicine (Internal Medicine) Physician | 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 DirectoryNPI 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.