NPIMap

Organization Active NPI

Vytalize Health

  • Family Medicine Physician
  • Carthage, MS
National Provider Identifier
1568083533
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VYTALIZE HEALTH
Practice address
1071 E Franklin St
Carthage, MS 39051-3601
Phone
(601) 267-4562
NPI assigned
May 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Authorized official

Name
Mr. Faris Ghawi
Title
Ceo / Co-Founder
Phone
(202) 286-6666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1071 E Franklin St
Carthage, MS 39051-3601

Mailing address

2 Hudson PL FL 6
Hoboken, NJ 07030-5594
Phone (201) 205-2628

Other practice location 1

2 Hudson Pl Fl 6
Hoboken, NJ 07030-5594
Phone (201) 205-2628

Other practice location 2

1111 Medical Center Blvd Ste S340
Marrero, LA 70072-3154
Phone (201) 205-2628

National Provider Directory

National Provider Directory

Locations

1111 Medical Center Blvd
Ste S340
Marrero, LA 70072
Phone (504) 328-5703

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1568083533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HUDSON PL FL 6",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305594",
            "telephone_number": "201-205-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 E FRANKLIN ST",
            "city": "CARTHAGE",
            "state": "MS",
            "postal_code": "390513601",
            "telephone_number": "601-267-4562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Hudson Pl Fl 6",
            "address_purpose": "LOCATION",
            "city": "Hoboken",
            "state": "NJ",
            "postal_code": "070305594",
            "country_code": "US",
            "telephone_number": "201-205-2628",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 Medical Center Blvd Ste S340",
            "address_purpose": "LOCATION",
            "city": "Marrero",
            "state": "LA",
            "postal_code": "700723154",
            "country_code": "US",
            "telephone_number": "201-205-2628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VYTALIZE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-01",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "GHAWI",
        "authorized_official_first_name": "FARIS",
        "authorized_official_title_or_position": "CEO / CO-FOUNDER",
        "authorized_official_telephone_number": "202-286-6666",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.