VITALIS WELLNESS CENTER, AZ PC
NPI 1497421101
Psychiatry & Neurology - Brain Injury Medicine in Mesa, AZ

Q: What is Vitalis Wellness Center Of Phoenix, Az PC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Brain Injury Medicine, with taxonomy code 2084P0301X.

Active since August 22, 2021

1910 S STAPLEY DR STE 120, MESA, AZ 85204(800) 922-1873 Get Directions Write a Review

NPPES record last updated: July 19, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 19, 2024, Aug 22, 2021 (2 updates tracked since 2021).

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About Vitalis Wellness Center, Az Pc NPPES

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

VITALIS WELLNESS CENTER, AZ PC (NPI 1497421101) is a healthcare organization registered as a brain injury medicine in Mesa, Arizona and active in the NPI registry since August 2021. The organization lists Nellie Idara Samuel, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1497421101

Entity TypeOrganization

Primary Taxonomy2084P0301X

Legal Business NameVITALIS WELLNESS CENTER OF PHOENIX, AZ PC

Location Address1910 S STAPLEY DR STE 120Mesa, AZ 85204-6676

Mailing Address1910 S Stapley Dr Ste 120Mesa, AZ 85204-6676 · (800) 922-1873

Phone(800) 922-1873

Organization SubpartNo

Authorized OfficialNellie Idara SamuelCo-owner · (800) 922-1873

Enumeration DateAugust 22, 2021

Last NPPES UpdateJuly 19, 20242 updates tracked since enumeration

NPPES CertifiedJuly 16, 2024

✔ NPI 1497421101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · Brain Injury MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2084P0301X

Definition

A Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical, physical, neurologic, cognitive, sensory, and behavioral disorders that result in psychosocial, educational, and vocational consequences.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X

Also ListedPsychiatry & Neurology · Child & Adolescent PsychiatryTaxonomy 2084P0804X

1910 S STAPLEY DR STE 120, Mesa, AZ 85204

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Other Names 1

Doing Business AsVitalis Wellness Center, Az Pc

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 MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INTERNAL MEDICINE AND INFUSION CLINIC OF SOUTHERN ARIZONA

Clinic/Center