Vitality Wellness, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

VITALITY WELLNESS, LLC

Practice address

3881 Ten Oaks Rd Ste 1D
Glenelg, MD 21737-9760

Phone

(540) 287-1776

NPI assigned

Feb 15, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Glenn Molin, D.C.NPI 1871960344

Title

Owner

Phone

(540) 287-1776

Specialties & licenses 1

Addresses

Other names 1

• Ten Oaks Health and Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glenn Molin, D.C.

  • Chiropractor
  • Glenelg, MD
  • NPI 1871960344
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1613347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613347200000",
    "number": "1972196541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13125 FOX PATH LN",
            "city": "WEST FRIENDSHIP",
            "state": "MD",
            "postal_code": "217949536",
            "telephone_number": "540-287-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3881 TEN OAKS RD STE 1D",
            "city": "GLENELG",
            "state": "MD",
            "postal_code": "217379760",
            "telephone_number": "540-287-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-15",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A",
        "authorized_official_last_name": "MOLIN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-287-1776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ten Oaks Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Glenelg, MD
• Providers in Glenelg, MD by specialty
• Chiropractor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.