Vital Branch Wellness Solutions LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

VITAL BRANCH WELLNESS SOLUTIONS LLC

Practice address

8156 Myrtlewood Rd
Greenwood, LA 71033-3024

Phone

(318) 773-8241

NPI assigned

Sep 24, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Alexandra Stewart, APRN-CNP

Title

Manager

Phone

(318) 773-8241

Specialties & licenses 5

Addresses

Locations

Practitioners 1

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

• Alexandra Jones Stewart, NP

  • Family Nurse Practitioner
  • Shreveport, LA
  • NPI 1700166717
  NPD

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1831916451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 YOUREE DR STE 1",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711043640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8156 MYRTLEWOOD RD",
            "city": "GREENWOOD",
            "state": "LA",
            "postal_code": "710333024",
            "telephone_number": "318-773-8241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL BRANCH WELLNESS SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "318-773-8241",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LS0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kelvin Sims
• Deshonda Bolden Tucker, FNP

• Multi-Specialty Clinic/Center in Greenwood, LA
• Providers in Greenwood, LA by specialty
• Multi-Specialty Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.