VITALITY HEALTH AND GLOW CLINIC
NPI 1902610447
Clinic/Center - Primary Care in Hiram, GA
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 holds a CLIA Waiver certificate valid through November 19, 2026 and lists Crystal Bailey, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 11D2314465
Vitality Health And Glow Clinic · Hiram, GAFrequently 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.
Does Vitality Health And Glow Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D2314465) is associated with this NPI, valid through November 19, 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 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.
# Vitality Health And Glow Clinic · NPI 1902610447
Primary Care organization in Hiram, Georgia. Organization record, active in the CMS NPPES registry since February 5, 2025.
## Identity
- **NPI:** 1902610447 (Entity type: Organization)
- **Enumerated:** February 5, 2025
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Crystal Bailey, CEO
## Practice location
- **Address:** 44 DARBYS CROSSING DR STE 110A, Hiram, GA 30141-6048
- **Phone:** (770) 575-0022
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 19, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1902610447) · Data from the CMS NPPES public registry.