Vitality Medical Centers, Inc.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

VITALITY MEDICAL CENTERS, INC.

Practice address

101 Medical Cir Ste a
West Columbia, SC 29169-3650

Phone

(803) 244-9212

Fax

(803) 708-0865

NPI assigned

Jun 15, 2011

Organization subpart

No

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

Authorized official

Name

Jason B Farmer

Title

Owner

Phone

(803) 244-9212

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Vitality Spine Center, Inc. Former legal business name

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1982999249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7227",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291717227",
            "telephone_number": "803-244-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEDICAL CIR STE A",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693650",
            "telephone_number": "803-244-9212",
            "fax_number": "803-708-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY MEDICAL CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-15",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-244-9212"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6730",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME PTAN",
            "identifier": "7059550001",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitality Spine Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Vitality Spine Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jannette Velez-Nieves
• Vibrance Screening and Wellness LLC
• Wilfredo Austin Villarrubia, PA-C
• Zackary Stark Vincent, MD
• Vision Therapy Institute of SC
• Vitality Medical Dispensary, Inc.
• Thanh Vo
• Samuel Wachter, APRN
• Veronica S. Wactor, NP
• Summer Wadford

• Physical Medicine & Rehabilitation Physician in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Physical Medicine & Rehabilitation Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.