Vitalocity Urgent Care, LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

VITALOCITY URGENT CARE, LLC

Practice address

118 Azalea Rd
St 1
Baxley, GA 31513

Phone

(912) 785-2676

NPI assigned

Sep 9, 2024

Organization subpart

No

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

Authorized official

Name

Roscoe Carl Walls, FNP-BCNPI 1376231597

Title

Owner

Phone

(912) 785-2676

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roscoe Carl Walls Jr., FNP-BC

  • Family Nurse Practitioner
  • Baxley, GA
  • NPI 1376231597
  Medicare reassignment NPD Authorized official
• Amanda Nicole Deen, MSN, FNP-BC

  • Family Nurse Practitioner
  • Baxley, GA
  • NPI 1437643517
  Medicare reassignment

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1124854153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 AZALEA RD",
            "address_2": "ST 1",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "31513",
            "telephone_number": "912-309-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 AZALEA RD",
            "address_2": "ST 1",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "31513",
            "telephone_number": "912-785-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALOCITY URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "ROSCOE",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-785-2676",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376231597",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Three Rivers EMS LLC
• Logan Brooke Tillman, FNP
• Tissue Issue Inc
• Toni Miles Tomberlin
• Vidalia Health Services, LLC
• Wal-Mart Stores East LP
• Walk by Faith Family Care
• Chyna Walker
• Roscoe Carl Walls Jr., FNP-BC
• Melissa Walsh, RPH

• Urgent Care Clinic/Center in Baxley, GA
• Providers in Baxley, GA by specialty
• Urgent Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.