=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184538308
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VIBRANT FAMILY HEALTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2026
-----------------------------------------------------
Last Update Date | 10/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 433 S GARRISON AVE
-----------------------------------------------------
City | CARTHAGE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64836-1749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 417-359-8646
-----------------------------------------------------
Fax | 417-359-8344
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 433 S GARRISON AVE
-----------------------------------------------------
City | CARTHAGE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64836-1749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 417-359-8646
-----------------------------------------------------
Fax | 417-359-8344
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | BRITTANY MAGGARD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 417-359-8646
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------