Vital Physician Services PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

VITAL PHYSICIAN SERVICES PLLC

Practice address

3720 Gattis School Rd Ste 800
Round Rock, TX 78664-4660

Phone

(808) 646-1691

NPI assigned

Jul 14, 2021

Organization subpart

No

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

Authorized official

Name

Jeffrey Daniel Hannah, PA-CNPI 1447676796

Title

Owner

Phone

(737) 222-5553

Specialties & licenses 3

Addresses

Other names 1

• Evolution Health Services Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

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 4

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

• Jeffrey Daniel Hannah

  • Physician Assistant
  • Round Rock, TX
  • NPI 1447676796
  Medicare reassignment Authorized official
• Mario Anthony Martinez, MD

  • Infectious Disease Physician
  • Waco, TX
  • NPI 1811425820
  Medicare reassignment NPD
• Christopher Paul Hall, D.O.

  • Emergency Medicine Physician
  • Du Bois, PA
  • NPI 1780905091

  General Practice, TX

  Medicare reassignment NPD
• Justin Mueller

  • Physician Assistant
  • San Antonio, TX
  • NPI 1831879758
  NPD (past)

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1801468210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 GATTIS SCHOOL RD STE 800",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786644660",
            "telephone_number": "737-222-5553",
            "fax_number": "833-907-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 GATTIS SCHOOL RD STE 800",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786644660",
            "telephone_number": "808-646-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL PHYSICIAN SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A",
        "authorized_official_last_name": "HANNAH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "737-222-5553",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolution Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Juliana Katherine Viro, OTR
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• Visionworks, Inc.
• Linda A Vitale, P.A.
• Viva Health Clinic, LLC
• Frederick Phat Ngoc Vo, PHARMD
• Sameera Vohra, M.D
• Aden Thomas Von Arx

• Clinic/Center in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.