VITALITY MOBILE WOUND CARE LLC
NPI 1811876824
Nurse Practitioner - Family in Tyler, TX
About Vitality Mobile Wound Care Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VITALITY MOBILE WOUND CARE LLC (NPI 1811876824) is a healthcare organization registered as a family in Tyler, Texas and active in the NPI registry since September 2025. The organization lists Christopher Lamar Ethridge, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Vitality Mobile Wound Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Vitality Mobile Wound Care LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Mobile Wound Care LLC's NPI number?
The NPI number for Vitality Mobile Wound Care LLC is 1811876824. It was assigned to this organization in the NPPES registry on September 2, 2025.
Where is Vitality Mobile Wound Care LLC located?
Vitality Mobile Wound Care LLC is located at 6115 New Copeland Rd Ste 640, Tyler, TX 75703. The listed phone number is (903) 420-3443.
What is Vitality Mobile Wound Care LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Vitality Mobile Wound Care LLC enrolled in Medicare?
Yes. Vitality Mobile Wound Care LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Vitality Mobile Wound Care LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Vitality Mobile Wound Care LLC, in Certified Clinical Nurse Specialist (CNS) and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Vitality Mobile Wound Care LLC accept?
Health plans from Blue Cross and Blue Shield of Texas and Molina Healthcare list Vitality Mobile Wound Care LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Vitality Mobile Wound Care LLC was last updated on June 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Vitality Mobile Wound Care Llc · NPI 1811876824
Family organization in Tyler, Texas. Organization record, active in the CMS NPPES registry since September 2, 2025.
## Identity
- **NPI:** 1811876824 (Entity type: Organization)
- **Enumerated:** September 2, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Christopher Ethridge, CEO
## Practice location
- **Address:** 6115 NEW COPELAND RD STE 640, Tyler, TX 75703-6368
- **Phone:** (903) 420-3443
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Certified Clinical Nurse Specialist (CNS) (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 8, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1811876824) · Data from the CMS NPPES public registry.