Vitality Health Primary Care LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

VITALITY HEALTH PRIMARY CARE LLC

Practice address

360 Racetrack Rd
McDonough, GA 30252-1022

Phone

(470) 377-6282

NPI assigned

Jun 3, 2024

Organization subpart

No

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

Authorized official

Name

Darnella Crowder

Title

Owner/FNP-C

Phone

(404) 704-6283

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1649011842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 LANDON DR",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302482462",
            "telephone_number": "404-704-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 RACETRACK RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302521022",
            "telephone_number": "470-377-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY HEALTH PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "CROWDER",
        "authorized_official_first_name": "DARNELLA",
        "authorized_official_title_or_position": "OWNER/FNP-C",
        "authorized_official_telephone_number": "404-704-6283"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in McDonough, GA
• Providers in McDonough, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.