Vitalcare Medical, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00486800 Issued in NJ

Legal business name

VITALCARE MEDICAL, LLC

Practice address

34 Union Ave
Suite 1
Irvington, NJ 07111-3219

Phone

(973) 985-8382

NPI assigned

Mar 8, 2017

Last updated

Mar 8, 2017By 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

Ms. Tamica Sheila Lawson, APN

Title

Ceo

Phone

(973) 985-8382

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1831639954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8210",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070288210",
            "telephone_number": "973-985-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 UNION AVE",
            "address_2": "SUITE 1",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113219",
            "telephone_number": "973-985-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALCARE MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "TAMICA",
        "authorized_official_middle_name": "SHEILA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-985-8382",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00486800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0417106",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.