Vitality Medical Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

108125 Issued in MO

Legal business name

VITALITY MEDICAL CORP

Practice address

9051 Watson Rd
Suite 343
Saint Louis, MO 63126-2240

Phone

(314) 556-5775

NPI assigned

Aug 25, 2010

Organization subpart

No

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

Authorized official

Name

Drew Shoemaker

Title

Ceo

Phone

(314) 556-5775

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1881900025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9051 WATSON RD",
            "address_2": "SUITE 343",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631262240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9051 WATSON RD",
            "address_2": "SUITE 343",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631262240",
            "telephone_number": "314-556-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-25",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "SHOEMAKER",
        "authorized_official_first_name": "DREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-556-5775"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "108125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vitalis Home Care Inc
• Vitalis Home Health Care Inc
• Vitalis Hospice Care Inc
• Vitality Home Health LLC
• Vitality Medical and Wellness Consulting LLC
• Vitality Spine and Sport
• Vitalskin Medical Group Il PLLC
• Vitas Healthcare Corporation Midwest
• Irena Vivian Vitkovitsky, MD
• Christine Viviano

• Family Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.