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VITALITY CARE CENTER PLLC
NPI 1114575578
Family Medicine in Prescott, AZ

Active since August 29, 2019
1003 DIVISION ST STE 8, PRESCOTT, AZ 86301(928) 632-0730 Get Directions Write a Review

NPPES record last updated: March 10, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 10, 2020, Dec 19, 2019, Aug 29, 2019 (3 updates tracked since 2019).

About Vitality Care Center Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VITALITY CARE CENTER PLLC (NPI 1114575578) is a healthcare organization registered as a family medicine in Prescott, Arizona and active in the NPI registry since August 2019. The organization lists Clarke Krugman, Owner, as its authorized official.

NPPES Registry Identity

NPI1114575578
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameVITALITY CARE CENTER PLLC
Location Address1003 DIVISION ST STE 8Prescott, AZ 86301-1657
Mailing Address7760 E. State Route 69, Suite C-5 Box 360Prescott Valley, AZ 86314 · (928) 225-2560
Phone(928) 632-0730
Organization SubpartNo
Authorized OfficialClarke KrugmanOwner · (928) 713-8385
Enumeration DateAugust 29, 2019
Last NPPES UpdateMarch 10, 20203 updates tracked since enumeration
NPPES CertifiedMarch 10, 2020
✔ NPI 1114575578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
1003 DIVISION ST STE 8, Prescott, AZ 86301
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Other Identifiers 1

Medicaid530064AZ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vitality Care Center PLLC's NPI number?

The NPI number for Vitality Care Center PLLC is 1114575578. It was assigned to this organization in the NPPES registry on August 29, 2019.

Where is Vitality Care Center PLLC located?

Vitality Care Center PLLC is located at 1003 Division St Ste 8, Prescott, AZ 86301. The listed phone number is (928) 632-0730.

What is Vitality Care Center PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Vitality Care Center PLLC was last updated on March 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.