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VIVASALUD CLINIC 1 LLC
NPI 1386361756
Family Medicine in Snellville, GA

Active since October 25, 2022CLIA 11D2272915 · Waiver
2336 WISTERIA DR STE 110, SNELLVILLE, GA 30078(470) 342-8500 Get Directions Write a Review

NPPES record last updated: February 15, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 13, 2023, Nov 24, 2022, Oct 25, 2022 (3 updates tracked since 2022).

About Vivasalud Clinic 1 Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VIVASALUD CLINIC 1 LLC (NPI 1386361756) is a healthcare organization registered as a family medicine in Snellville, Georgia and active in the NPI registry since October 2022. The organization holds a CLIA Waiver certificate valid through December 1, 2026 and lists Vanessa Jimenez, Chief Clinical Operations Officer, as its authorized official.

NPPES Registry Identity

NPI1386361756
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameVIVASALUD CLINIC 1 LLC
Location Address2336 WISTERIA DR STE 110Snellville, GA 30078-6162
Mailing Address2336 Wisteria Dr Ste 110Snellville, GA 30078-6162 · (470) 481-7803 · Fax (833) 941-5113
Phone(470) 342-8500
Organization SubpartNo
Authorized OfficialVanessa JimenezChief Clinical Operations Officer · (470) 607-5533
Enumeration DateOctober 25, 2022
Last NPPES UpdateFebruary 15, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 15, 2026
✔ NPI 1386361756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2336 WISTERIA DR STE 110, Snellville, GA 30078
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Other Identifiers 1

Medicaid003284553AGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2272915

Vivasalud Clinic 1, LLC · Snellville, GA
Active · expires Dec 1, 2026
CLIA Number11D2272915
Laboratory TypePractitioner Other
Certificate Effective DateDecember 2, 2024
Certificate Expiration DateDecember 1, 2026
Laboratory DirectorVanessa Jimenez
Laboratory Phone(470) 481-7803
Laboratory LocationVivasalud Clinic 1, LLC2336 Wisteria Drive Suite 110, Snellville, GA 30078
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VANESSA JIMENEZ NP
Nurse Practitioner (Family)
2336 WISTERIA DR STE 110
SNELLVILLE, GA 30078
Gwinnett County (470) 481-7803

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vivasalud Clinic 1 LLC's NPI number?

The NPI number for Vivasalud Clinic 1 LLC is 1386361756. It was assigned to this organization in the NPPES registry on October 25, 2022.

Where is Vivasalud Clinic 1 LLC located?

Vivasalud Clinic 1 LLC is located at 2336 Wisteria Dr Ste 110, Snellville, GA 30078. The listed phone number is (470) 342-8500.

What is Vivasalud Clinic 1 LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Vivasalud Clinic 1 LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2272915) is associated with this NPI, valid through December 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Vivasalud Clinic 1 LLC was last updated on February 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.