Vibrant Living Wellness Center

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

294 Issued in GA

Legal business name

VIBRANT LIVING WELLNESS CENTER

Practice address

180 W Walnut St
Jesup, GA 31545-1325

Phone

(912) 424-2871

Fax

(912) 307-3874

NPI assigned

Oct 21, 2016

Last updated

Oct 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leona Harter, L.AC.

Title

Owner/Acupuncturist

Phone

(912) 424-2871

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1154872448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 W WALNUT ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451325",
            "telephone_number": "912-424-2871",
            "fax_number": "912-307-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 W WALNUT ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451325",
            "telephone_number": "912-424-2871",
            "fax_number": "912-307-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT LIVING WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "HARTER",
        "authorized_official_first_name": "LEONA",
        "authorized_official_title_or_position": "OWNER/ACUPUNCTURIST",
        "authorized_official_telephone_number": "912-424-2871",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "GA",
            "license": "294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather F Tyre, PA-C
• Leslie Brook Tzen, NP
• Unihealth Solutions of North Georgia, Inc. (UniHealth SOURCE of Jesup)
• John Matthew Valosen, M.D.
• Amy Vargas, FNP-C
• VN Properties Inc (Peach Family Healthcare)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2630)
• Wal-Mart Stores East, LP (Vision Center 30-2630)
• Walgreen Co (Walgreens #11792)
• Jessica Walker, PHARMD

• Point of Service in Jesup, GA
• Providers in Jesup, GA by specialty
• Point of Service in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.