VITALITY HEALTH AND GLOW CLINIC
NPI 1902610447
Clinic/Center - Primary Care in Hiram, GA

Active since February 05, 2025
44 DARBYS CROSSING DR STE 110A, HIRAM, GA 30141(770) 575-0022 Get Directions Write a Review

NPPES record last updated: March 19, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Mar 19, 2026, Feb 5, 2025 (2 updates tracked since 2025).

About Vitality Health And Glow Clinic NPPES

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

VITALITY HEALTH AND GLOW CLINIC (NPI 1902610447) is a healthcare organization registered as a primary care in Hiram, Georgia and active in the NPI registry since February 2025. The organization lists Crystal Bailey, Ceo, as its authorized official.

NPPES Registry Identity

NPI1902610447
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameVITALITY HEALTH AND GLOW CLINIC
Location Address44 DARBYS CROSSING DR STE 110AHiram, GA 30141-6048
Mailing Address44 Darbys Crossing Dr Ste 110aHiram, GA 30141-6048 · (770) 575-0022 · Fax (770) 492-4169
Organization SubpartNo
Authorized OfficialCrystal BaileyCeo · (404) 682-8567
Enumeration DateFebruary 5, 2025
Last NPPES UpdateMarch 19, 20262 updates tracked since enumeration
NPPES CertifiedMarch 19, 2026
✔ NPI 1902610447 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
44 DARBYS CROSSING DR STE 110A, Hiram, GA 30141

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 Health And Glow Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Vitality Health And Glow Clinic, which bills Medicare for the services this clinician delivers.

Clinician (1)

Nurse Practitioner
NPI 1225635212
44 DARBYS CROSSING DR STE 110A
Hiram, GA 30141
(770) 575-0022
✔ PECOSSame address

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 Health And Glow Clinic's NPI number?

The NPI number for Vitality Health And Glow Clinic is 1902610447. It was assigned to this organization in the NPPES registry on February 5, 2025.

Where is Vitality Health And Glow Clinic located?

Vitality Health And Glow Clinic is located at 44 Darbys Crossing Dr Ste 110A, Hiram, GA 30141. The listed phone number is (770) 575-0022.

What is Vitality Health And Glow Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Vitality Health And Glow Clinic enrolled in Medicare?

Yes. Vitality Health And Glow Clinic is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Vitality Health And Glow Clinic?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Vitality Health And Glow Clinic. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Vitality Health And Glow Clinic was last updated on March 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.