Organization Active NPI

Vibrant Life Health Center LLC

  • Point of Service
  • Jacksonville, FL
National Provider Identifier
1992110654
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
CH11201 Issued in FL
Legal business name
VIBRANT LIFE HEALTH CENTER LLC
Practice address
11798 San Jose Blvd Ste 2
Jacksonville, FL 32223-1836
Phone
(904) 682-8177
Fax
(904) 738-7483
NPI assigned
Jun 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Authorized official

Name
Dr. Jon Claude Thomas, D.CNPI 1386054658
Title
Doctor/Owner
Phone
(904) 683-8177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X CH11201 FL Primary

Addresses

Primary practice location

11798 San Jose Blvd Ste 2
Jacksonville, FL 32223-1836

Mailing address

11798 San Jose Blvd Ste 2
Jacksonville, FL 32223-1836
Phone (904) 682-8177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140627001391 FL Part B Supplier - Clinic/Group Practice 9335364793 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

12627 San Jose Blvd
Ste 501
Jacksonville, FL 32223
Phone (904) 683-8177

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1403308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1992110654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11798 SAN JOSE BLVD STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231836",
            "telephone_number": "904-682-8177",
            "fax_number": "904-738-7483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11798 SAN JOSE BLVD STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231836",
            "telephone_number": "904-682-8177",
            "fax_number": "904-738-7483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT LIFE HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-21",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "CLAUDE",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "904-683-8177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "FL",
            "license": "CH11201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.