Healthcare Provider Details
I. General information
NPI: 1437045044
Provider Name (Legal Business Name): VIBRANT HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/18/2025
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3425 AUSTIN BLUFFS PKWY STE 100
COLORADO SPRINGS CO
80918-5701
US
IV. Provider business mailing address
3425 AUSTIN BLUFFS PKWY STE 100
COLORADO SPRINGS CO
80918-5701
US
V. Phone/Fax
- Phone: 307-340-1654
- Fax: 303-306-7753
- Phone: 307-340-1654
- Fax: 303-306-7753
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JILL
VESSEY
Title or Position: OWNER
Credential: MD
Phone: 719-632-4455