VITALITY MEDICAL CLINIC AND SPA
NPI 1760741698
Specialist in D'iberville, MS

Q: What is Vitality Wellness Clinic LLC's NPI number?

The NPI number for Vitality Wellness Clinic LLC is 1760741698. It was assigned to this organization in the NPPES registry on May 12, 2012. The provider is doing business as Vitality Medical Clinic And Spa.

Q: What is Vitality Wellness Clinic LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since May 12, 2012

3200 MALLETT RD, D-3, D'IBERVILLE, MS 39540(228) 392-0900(228) 392-0902 Get Directions Write a Review

NPPES record last updated: August 28, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Vitality Medical Clinic And Spa NPPES

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

VITALITY MEDICAL CLINIC AND SPA (NPI 1760741698) is a healthcare organization registered as a specialist in D'iberville, Mississippi and active in the NPI registry since May 2012. The organization lists Jason Bradley Crowder, Owner, as its authorized official.

NPPES Registry Identity

NPI1760741698

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameVITALITY WELLNESS CLINIC LLC

Location Address3200 MALLETT RD, D-3D'iberville, MS 39540-9305

Mailing Address3200 Mallett Rd, Suite D-3D'iberville, MS 39540-9305 · (228) 392-0900 · Fax (228) 392-0902

Phone(228) 392-0900

Fax(228) 392-0902

Organization SubpartNo

Authorized OfficialJason Bradley CrowderOwner · (251) 591-9769

Enumeration DateMay 12, 2012

Last NPPES UpdateAugust 28, 2012

✔ NPI 1760741698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in MS · 20041

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

3200 MALLETT RD, D'iberville, MS 39540

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Other Names 1

Doing Business AsVitality Medical Clinic And Spa

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

TOTAL RENAL CARE INC

Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)

3200 MALLETT RD, STE F
D'IBERVILLE, MS 39540

Harrison County (228) 354-9578

COMPASS IMAGING LLC

Physiological Laboratory

3200 MALLETT RD, SUITE E-2
DIBERVILLE, MS 39540

Harrison County (228) 314-7226

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 Vitality Wellness Clinic LLC's NPI number?

The NPI number for Vitality Wellness Clinic LLC is 1760741698. It was assigned to this organization in the NPPES registry on May 12, 2012. The provider is doing business as Vitality Medical Clinic And Spa.

Where is Vitality Wellness Clinic LLC located?

Vitality Wellness Clinic LLC is located at 3200 Mallett Rd D-3, D'iberville, MS 39540. The listed phone number is (228) 392-0900.

What is Vitality Wellness Clinic LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Vitality Wellness Clinic LLC was last updated on August 28, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.