Organization Active NPI

Vital Nursing Care

  • Home Health Agency
  • Burbank, CA
National Provider Identifier
1124661319
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
VITAL NURSING CARE
Practice address
3017 N San Fernando Blvd Ste a
Burbank, CA 91504-4704
Phone
(888) 404-0494
Fax
(888) 404-0479
NPI assigned
Oct 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edward Otuzbiryan
Title
Ceo
Phone
(888) 404-0494

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3017 N San Fernando Blvd Ste a
Burbank, CA 91504-4704

Mailing address

3017 N San Fernando Blvd Ste a
Burbank, CA 91504-4704
Phone (888) 404-0494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200928002787 CA Part A Provider - Home Health Agency 1951736354 Practice locations: Burbank, CA

Home health agency certification: CCN 559639

Legal name
VITAL NURSING CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 30, 2021
Last certification
Oct 30, 2021
Organization structure
CorporationProprietary
Incorporated
Oct 3, 2019 in CA
Enrollment address
3017 N San Fernando Blvd
Unit a
Burbank, CA 91504-4704
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Vital Nursing CareCCN 559639
Overall star rating
5 of 5
Ownership
-
Certified
Sep 30, 2021
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2188376Vital Nursing Care3017 N San Fernando Blvd, Ste a, Burbank, CA 91504Certificate of waiverJul 15, 2026

National Provider Directory

National Provider Directory

Locations

3017 N San Fernando Blvd
#A
Burbank, CA 91504
Phone (818) 442-2797

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Edward Otuzbiryan Individual 5% Or Greater Direct Ownership InterestOwner Aug 22, 2020 100%
Corporate OfficerCeo/Cfo/Secretary/Board Member Aug 22, 2020 100%
Corporate DirectorCeo/Cfo/Secretary/Board Member Aug 22, 2020 100%
W-2 Managing EmployeeCeo/Cfo/Secretary/Board Member Aug 22, 2020 100%

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1124661319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 N SAN FERNANDO BLVD STE A",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915044704",
            "telephone_number": "888-404-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 N SAN FERNANDO BLVD STE A",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915044704",
            "telephone_number": "888-404-0494",
            "fax_number": "888-404-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL NURSING CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "OTUZBIRYAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-404-0494"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.