VITALITY CARE CENTER PLLC (NPI# 1114575578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114575578 |
| Entity Type | Organization |
| Organization Name | VITALITY CARE CENTER PLLC |
| Practice Address |
1003 Division St Ste 8 Prescott AZ 86301-1657 |
| Mailing Address |
7760 E. State Route 69 Suite C-5 Box 360 Prescott Valley AZ 86314 |
| Practice Telephone | 9286320730 |
| Mailing Telephone | 9282252560 |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2020-03-10 |
| Authorized Official Name | CLARKE KRUGMAN (OWNER) |
| Authorized Official Telephone | 9287138385 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 530064 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | VITALITY CARE CENTER PLLC | 5159 South Santa Fe, Guthrie, OK 73044 |
| Street Address |
1003 DIVISION ST STE 8 |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301-1657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518357730 | Clarke Krugman | Registered Nurse | 1003 Division St Ste 8, Prescott, AZ 86301-1657 | 2015-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
| 1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
| 1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
| 1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
| 1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
| 1275925265 | Oral and Facial Surgery Center of Prescott | Dentist | 5415 Distiction Way, Prescott, AZ 86301 | 2015-02-27 |
| Find all providers in zip 86301 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1205309812 | Priority Family Medical Clinic LLC | Family Medicine | 3625 Crossings Dr Ste B, Prescott, AZ 86305-7159 | 2019-01-07 |
| 1740462779 | Lawrence H Borish | Family Medicine | 4100 W Marlow Rd, Prescott, AZ 86305-5511 | 2007-11-30 |
| 1295940351 | Kevin S Doyle Md Pllc | Family Medicine | 905 Angelita Dr, Prescott, AZ 86303-5019 | 2007-05-11 |
| 1811029804 | Keith Marion Keating | Family Medicine | 3607 Crossings Dr Ste B, Prescott, AZ 86305-7149 | 2007-03-12 |
| 1124156997 | Irene Anna Royko | Family Medicine | 1654 Coyote Rd, Prescott, AZ 86303-5339 | 2007-03-01 |
| 1144398355 | Mark Everett Kiffer | Family Medicine | 6200 W Indian Pony Ct, Prescott, AZ 86305-1542 | 2006-12-04 |
| 1023181583 | Robert Jeffrey Zieve | Family Medicine | 343 S Montezuma St, Prescott, AZ 86303-7022 | 2006-11-15 |
| 1154413789 | Kenneth Purdy Archer | Family Medicine | 1003 Division Street, Suite # 3, Prescott, AZ 86301-1657 | 2006-09-29 |
| 1730289380 | Ellen F. Bunch | Family Medicine | 1530 W Cliff Rose Rd, Prescott, AZ 86305-7434 | 2006-09-24 |
| Find all providers in PRESCOTT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.