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MINNESOTA VITALITY AND ANTI-AGING CENTER
NPI 1598330219
Clinic/Center in Shoreview, MN

Active since May 25, 2021CLIA Certified · 2 labs
520 HIGHWAY 96 W STE 200, SHOREVIEW, MN 55126(651) 374-4014(651) 374-4019 Get Directions Write a Review

NPPES record last updated: June 24, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jun 24, 2025, Nov 21, 2023, Aug 3, 2021 and 2 more (5 updates tracked since 2021).

About Minnesota Vitality And Anti-aging Center NPPES

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

MINNESOTA VITALITY AND ANTI-AGING CENTER (NPI 1598330219) is a healthcare organization registered as a clinic/center in Shoreview, Minnesota and active in the NPI registry since May 2021. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Forest Lake, and lists Heather Manship, Co-founder, as its authorized official.

NPPES Registry Identity

NPI1598330219
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameMINNESOTA VITALITY AND ANTI-AGING CENTER
Location Address520 HIGHWAY 96 W STE 200Shoreview, MN 55126-1963
Mailing Address520 Highway 96 W Ste 200Shoreview, MN 55126-1963 · (651) 374-4014 · Fax (651) 374-4019
Phone(651) 374-4014
Fax(651) 374-4019
Organization SubpartNo
Authorized OfficialHeather ManshipCo-founder · (651) 245-2454
Enumeration DateMay 25, 2021
Last NPPES UpdateJune 24, 20255 updates tracked since enumeration
NPPES CertifiedJune 24, 2025
✔ NPI 1598330219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · Women's HealthTaxonomy 363LW0102X
520 HIGHWAY 96 W STE 200, Shoreview, MN 55126
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Secondary Practice Location 1

Location 125 Lake St N Ste 120Forest Lake, MN 55025-2536 · Phone (651) 374-4014 · Fax (651) 374-4019

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2222038

Minnesota Vitality And Anti-Aging Center · Shoreview, MN
Active · expires Apr 26, 2027
CLIA Number24D2222038
Laboratory TypePractitioner Other
Certificate Effective DateApril 27, 2025
Certificate Expiration DateApril 26, 2027
Laboratory DirectorArazu Kian
Laboratory Phone(651) 374-4014
Laboratory LocationMinnesota Vitality And Anti-Aging Center520 Highway 96 West, Ste 200, Shoreview, MN 55126
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2222034

Minnesota Vitality And Anti Aging Center · Forest Lake, MN
Active · expires Apr 26, 2027
CLIA Number24D2222034
Laboratory TypePractitioner Other
Certificate Effective DateApril 27, 2025
Certificate Expiration DateApril 26, 2027
Laboratory DirectorArazu N. Kian
Laboratory Phone(651) 374-4014
Laboratory LocationMinnesota Vitality And Anti Aging Center25 N Lake Street #120, Forest Lake, MN 55025
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

AIMEE NEUMANN HEALTH AND WELLNESS, LLC
Nurse Practitioner (Women's Health)
520 HIGHWAY 96 W STE 200
SHOREVIEW, MN 55126
Ramsey County (651) 374-4014
LAUREN BRODZINSKI
Nurse Practitioner (Family)
520 HIGHWAY 96 W STE 200
SHOREVIEW, MN 55126
Ramsey County (860) 644-4241
MS. ERIN LAMANNA NP
Nurse Practitioner (Family)
520 HIGHWAY 96 W STE 200
SHOREVIEW, MN 55126
Ramsey County (651) 374-4014

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 Minnesota Vitality And Anti-Aging Center's NPI number?

The NPI number for Minnesota Vitality And Anti-Aging Center is 1598330219. It was assigned to this organization in the NPPES registry on May 25, 2021.

Where is Minnesota Vitality And Anti-Aging Center located?

Minnesota Vitality And Anti-Aging Center is located at 520 Highway 96 W Ste 200, Shoreview, MN 55126. The listed phone number is (651) 374-4014.

What is Minnesota Vitality And Anti-Aging Center's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Minnesota Vitality And Anti-Aging Center hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Minnesota Vitality And Anti-Aging Center was last updated on June 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.