MEDICARE: EMPOWERED VIRTUAL SOLUTIONS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1982555744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWERED VIRTUAL SOLUTIONS, INC.

Provider Business Mailing Address
First Line	:	103 CROSS CREEK DR
Second Line	:
City	:	POOLER
State	:	GA
Zip	:	31322-9305
Country	:	US
Telephone Number	:	912-663-1047
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 CROSS CREEK DR
Second Line	:
City	:	POOLER
State	:	GA
Zip	:	31322-9305
Country	:	US
Telephone Number	:	912-663-1047
Fax Number	:

Authorized Official
Title or Position	:	NON-CLINICAL CASE MANAGER
Name	:	SHARONDA BACON
Credential	:
Telephone Number	:	912-663-1047

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/08/2026

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