NPIMap

Organization Active NPI

Vitality Hospice Pennsylvania LLC

  • Community Based Hospice Care Agency
  • Langhorne, PA
National Provider Identifier
1245973288
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
VITALITY HOSPICE PENNSYLVANIA LLC
Practice address
3000 Cabot Blvd W Ste 200a
Langhorne, PA 19047-1800
Phone
(877) 288-0042
Fax
(877) 288-0043
NPI assigned
Apr 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Mrs. Tina Danielle KrajnikovichNPI 1750772562
Title
Ceo/Founder
Phone
(877) 288-0042

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

3000 Cabot Blvd W Ste 200a
Langhorne, PA 19047-1800

Mailing address

5647 Nash Dr
Pipersville, PA 18947-1119
Phone (877) 288-0042

Other names 1

  • Vitality Hospice and Palliative Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220926003392 PA Part A Provider - Hospice 5294111456 Practice locations: Langhorne, PA

Hospice certification: CCN 731506

Legal name
VITALITY HOSPICE PENNSYLVANIA LLC
Doing business as
VITALITY HOSPICE AND PALLIATIVE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 13, 2022
Last certification
Oct 13, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Enrollment address
3000 Cabot Blvd W
Ste 200a
Langhorne, PA 19047-1800

Care Compare: Hospice

Medicare Care Compare
Listed as
Vitality Hospice and Palliative CareCCN 731506
Certified
Oct 13, 2022
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
39D2266417Vitality Hospice Pennsylvania LLC3000 Cabot Blvd W, Langhorne, PA 19047Certificate of waiverAug 9, 2026

National Provider Directory

National Provider Directory

Locations

3000 Cabot Blvd W
Ste 200A
Langhorne, PA 19047
Phone (877) 288-0042

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
John Joseph Lawall Individual 5% Or Greater Indirect Ownership InterestNon Managing Member Mar 25, 2022 40%
Tina Danielle Krajnikovich Individual 5% Or Greater Indirect Ownership InterestCeo/President/Founder Mar 25, 2022 60%
Corporate OfficerCeo/President/Founder Mar 25, 2022
W-2 Managing EmployeeCeo/President/Founder Mar 25, 2022
Vitality Health Holdings LLC Organization, Pipersville, PA LLC 5% Or Greater Direct Ownership Interest Mar 25, 2022 100%
Patricia Ann Roth Individual Contracted Managing EmployeeMedical Director Feb 12, 2024
Nichole Rowe Individual Corporate OfficerCoo Apr 18, 2023
Yamira Diaz Individual W-2 Managing EmployeeAd; Jul 15, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1245973288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5647 NASH DR",
            "city": "PIPERSVILLE",
            "state": "PA",
            "postal_code": "189471119",
            "telephone_number": "877-288-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CABOT BLVD W STE 200A",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471800",
            "telephone_number": "877-288-0042",
            "fax_number": "877-288-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY HOSPICE PENNSYLVANIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "KRAJNIKOVICH",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "CEO/FOUNDER",
        "authorized_official_telephone_number": "877-288-0042",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitality Hospice and Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Langhorne, PA

Sources for this page

Verify at the official NPI Registry.