Vital Personalized Healthcare, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MDO 985 DO Issued in SC

Legal business name

VITAL PERSONALIZED HEALTHCARE, LLC

Practice address

23 Plantation Park Dr
BLDG 400
Bluffton, SC 29910

Phone

(803) 460-5699

NPI assigned

Nov 16, 2016

Organization subpart

No

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

Authorized official

Name

Christopher W. Leblanc, DONPI 1205875853

Title

Owner/Physician

Phone

(843) 815-5566

Specialties & licenses 1

Addresses

Other names 1

• Coastal Concierge Care, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in SC

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 1

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

• Christopher W. Leblanc, D.O.

  • Family Medicine Physician
  • Bluffton, SC
  • NPI 1205875853
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526947200000",
    "number": "1245772672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 PLANTATION PARK DR STE B",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299106038",
            "telephone_number": "803-460-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 PLANTATION PARK DR",
            "address_2": "BLDG 400",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "29910",
            "telephone_number": "803-460-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL PERSONALIZED HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-16",
        "last_updated": "2018-05-22",
        "status": "A",
        "authorized_official_last_name": "LEBLANC",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "843-815-5566",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "MDO 985 DO",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Concierge Care, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Allison Kathryn Vigil, N.P.
• Tracy Villalobos Campos, PT
• Vincent M Somaio, MD, LLC
• Vip Cosmetic Surgery, PA
• Virginia M. Boney, PH.D. LMFT, PA
• Daniel Jay Vogt, DMD
• Katharine Volz, MOT
• Madelyn Wagner
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP

• Family Medicine Physician in Bluffton, SC
• Providers in Bluffton, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.