Vitality Partners, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

VITALITY PARTNERS, LLC

Practice address

3355 Saint Johns LN Ste F
Ellicott City, MD 21042-2600

Phone

(240) 334-7650

Fax

(855) 697-2497

NPI assigned

Dec 17, 2020

Last updated

Dec 17, 2020By 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

Dr. Kimberly Camille Walker, MDNPI 1306024930

Title

Owner

Phone

(717) 497-4418

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly C Walker, MD

  • Child & Adolescent Psychiatry Physician
  • Columbia, MD
  • NPI 1306024930
  NPD Authorized official

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1154917748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 WOODLOT RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210445721",
            "telephone_number": "717-497-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 SAINT JOHNS LN STE F",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422600",
            "telephone_number": "240-334-7650",
            "fax_number": "855-697-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "CAMILLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-497-4418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jennifer O Vizcarrondo, PT
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• Psychiatry Physician in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.