OrganizationActive
Phoenix Vitality, LLC
NPI 1104776939 · General Practice Physician · Leipsic, OH
Provider details
- NPI number
- 1104776939
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Stephanie Rodriguez, Nurse Practitioner(419) 957-0631
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
603 E Main St
Leipsic, OH 45856-1438
Phone: (419) 957-9737
Street-level locationGet directions
Mailing address
603 E Main St
Leipsic, OH 45856-1438
Registry dates
- Enumerated
- 2026-01-31
- Last updated
- 2026-01-31
- Certified
- 2026-01-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.