Healthcare Provider Details

I. General information

NPI: 1124952635
Provider Name (Legal Business Name): VITAL LINK MEDICAL CONCIERGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8769 ELLIS MILL DR
GAINESVILLE VA
20155-5935
US

IV. Provider business mailing address

8769 ELLIS MILL DR
GAINESVILLE VA
20155-5935
US

V. Phone/Fax

Practice location:
  • Phone: 703-743-4200
  • Fax:
Mailing address:
  • Phone: 703-743-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: OMAR MOMODU KAMARA
Title or Position: FNP-C
Credential: FNP
Phone: 703-743-4200