Vitality Medical and Wellness Consulting LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VITALITY MEDICAL AND WELLNESS CONSULTING LLC

Practice address

3009 N Ballas Rd Ste 215B
Saint Louis, MO 63131-2323

Phone

(314) 695-8525

NPI assigned

Mar 5, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Amy Loden, MD

Title

Ceo

Phone

(314) 335-9151

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Anna Whaley Burke, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
  • NPI 1306409768
  Medicare reassignment NPD
• Brittney Marie Tihen, FNP

  • Nurse Practitioner
  • Saint Louis, MO
  • NPI 1740680685
  NPD (past)

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1992390421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 AMBERWOOD LN",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630215888",
            "telephone_number": "314-335-9151",
            "fax_number": "256-292-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 215B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312323",
            "telephone_number": "314-695-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY MEDICAL AND WELLNESS CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-05-03",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "LODEN",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-335-9151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas J Vitale, M.D.
• Vitalis Home Care Inc
• Vitalis Home Health Care Inc
• Vitalis Hospice Care Inc
• Vitality Home Health LLC
• Vitality Medical Corp
• Vitality Spine and Sport
• Vitalskin Medical Group Il PLLC
• Vitas Healthcare Corporation Midwest
• Irena Vivian Vitkovitsky, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.