Vitality Healthcare Services LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

VITALITY HEALTHCARE SERVICES LLC

Practice address

400 Plaza Cir Ste G
Clinton, SC 29325-7558

Phone

(864) 403-9150

NPI assigned

Oct 4, 2021

Last updated

Oct 4, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Tyrone G Roberson Sr., APRNNPI 1134428923

Title

Nurse Practitioner

Phone

(864) 403-9150

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tyrone G Roberson Sr., AGPCNP-BC

  • Nurse Practitioner
  • Columbia, SC
  • NPI 1134428923
  NPD Authorized official

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633305600000",
    "number": "1801568225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PLAZA CIR STE G",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293257558",
            "telephone_number": "864-403-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PLAZA CIR STE G",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293257558",
            "telephone_number": "864-403-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "864-403-9150",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allie Turpin, NURSE PRACTITIONER
• Upstate Affiliate Organization (GHS Laurens Co Mem Hosp Sub-Acute)
• Upstate Podiatry Group, PA
• Deborah E. Van Etten, RN
• Vitality Healthcare Services LLC
• Slade Christopher Walters, PA-C
• Nichole Anne Wargo, PHARMD
• James Lawrence Waring III, DO
• Rufus W Watkins, MD
• Jennifer Watson

• Clinic/Center in Clinton, SC
• Providers in Clinton, SC by specialty
• Clinic/Center in South Carolina

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