Vitality Mobile Wound Care LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

VITALITY MOBILE WOUND CARE LLC

Practice address

6115 New Copeland Rd Ste 640
Tyler, TX 75703-6368

Phone

(903) 420-3443

NPI assigned

Sep 2, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Lamar Ethridge

Title

Ceo

Phone

(903) 420-3446

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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

• Kelli Emeline Ivy, APRN, FNP-BC

  • Family Nurse Practitioner
  • Tyler, TX
  • NPI 1114673951
  Medicare reassignment Care Compare group NPD
• Patricia Ann Justice Stevenson, APRN

  • Adult Health Clinical Nurse Specialist
  • Tyler, TX
  • NPI 1417153776

  Wound Care

  Medicare reassignment Care Compare group NPD
• Kemmerly Elizabeth Walker, FNP-C

  • Family Nurse Practitioner
  • Ringgold, LA
  • NPI 1265189450

  TX

  Medicare reassignment

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

{
    "created_epoch": "1756771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1811876824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6115 NEW COPELAND RD STE 640",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757036368",
            "telephone_number": "903-420-3443",
            "fax_number": "903-630-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 NEW COPELAND RD STE 640",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757036368",
            "telephone_number": "903-420-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY MOBILE WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-02",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "ETHRIDGE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "LAMAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "903-420-3446",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virtuous Homecare LLC
• Visionworks, Inc.
• Vital Signs Pediatrics PLLC
• Vitality Center
• Vitality Clinics of East Texas, P.a.
• Christine Vo, PHARMD
• Elaine Tuong VI Vo, M.D.
• Honglam Thi Vo, DMD
• Caroline B Vogt
• Eric Bradley Vogt

• Family Nurse Practitioner in Tyler, TX
• Providers in Tyler, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.