Vital Wellnes Biloxi LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

VITAL WELLNES BILOXI LLC

Practice address

770 Water St
Biloxi, MS 39530-4220

Phone

(228) 265-2229

NPI assigned

Jun 30, 2022

Organization subpart

No

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

Authorized official

Name

Shantenette Joann Averett

Title

Nurse Manager

Phone

(228) 219-1314

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656547200000",
    "number": "1992437669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 WATER ST",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395304220",
            "telephone_number": "228-285-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 WATER ST",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395304220",
            "telephone_number": "228-265-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL WELLNES BILOXI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "AVERETT",
        "authorized_official_first_name": "SHANTENETTE",
        "authorized_official_middle_name": "JOANN",
        "authorized_official_title_or_position": "NURSE MANAGER",
        "authorized_official_telephone_number": "228-219-1314"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.