Vitalis Wound Care LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

VITALIS WOUND CARE LLC

Practice address

3062 Conquista CT
Las Vegas, NV 89121-3829

Phone

(702) 673-1930

NPI assigned

Apr 25, 2025

Organization subpart

No

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

Authorized official

Name

William Dela Paz

Title

Owner

Phone

(909) 910-2804

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 2

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

• Gerald Lynn Gibbs, APRN

  • Gerontology Nurse Practitioner
  • Las Vegas, NV
  • NPI 1700441094
  Medicare reassignment NPD
• Raymond Balagtas Tinio, NP

  • Acute Care Nurse Practitioner
  • Colton, CA
  • NPI 1033751938

  NV

  Medicare reassignment

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

{
    "created_epoch": "1745539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1417745936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3062 CONQUISTA CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3062 CONQUISTA CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213829",
            "telephone_number": "702-673-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALIS WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-25",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A",
        "authorized_official_last_name": "DELA PAZ",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-910-2804"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vital Rides LLC
• Vital Wound Care Inc
• Irene Reyes Vital
• Kahleen Anne Vinas Vital
• Mariafe Manalang Vital, APRN, FNP-C
• Vitality M12 LLC
• Vitality Medical and Wellness Center
• Vitality Medical Center
• Vitality Unlimited
• Vitalmind Health Services LLC

• Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.