1. Home
  2. Directory
  3. North Carolina
  4. Raleigh
  5. Family Medicine
  6. NPI Profile

RALEIGH FAMILY PRACTICE PA
NPI 1063571040
Family Medicine in Raleigh, NC

Active since December 06, 2006CLIA 34D0953471 · Accreditation
4414 LAKE BOONE TRL, SUITE 502, RALEIGH, NC 27607(919) 875-0539(919) 875-1051 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Raleigh Family Practice Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RALEIGH FAMILY PRACTICE PA (NPI 1063571040) is a healthcare organization registered as a family medicine in Raleigh, North Carolina and active in the NPI registry since December 2006. The organization holds an CLIA Accreditation certificate valid through September 19, 2027 and lists Kristin T Fisher, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1063571040
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameRALEIGH FAMILY PRACTICE PA
Location Address4414 LAKE BOONE TRL, SUITE 502Raleigh, NC 27607-7513
Mailing Address4414 Lake Boone Trl, Suite 502Raleigh, NC 27607-7513 · (919) 875-0539 · Fax (919) 875-1051
Phone(919) 875-0539
Fax(919) 875-1051
Organization SubpartNo
Authorized OfficialKristin T FisherPractice Administrator · (919) 875-0539
Enumeration DateDecember 6, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1063571040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NC · 84061
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4414 LAKE BOONE TRL, Raleigh, NC 27607
Open in Google Maps ↗

Other Identifiers 1

Medicaid7901842NC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Accreditation 34D0953471

Raleigh Family Practice · Raleigh, NC
Active · expires Sep 19, 2027
CLIA Number34D0953471
Laboratory TypePhysician Office
Certificate Effective DateSeptember 20, 2025
Certificate Expiration DateSeptember 19, 2027
Laboratory DirectorDr. Jaimita Patel
Laboratory Phone(919) 875-0539
Laboratory LocationRaleigh Family Practice4414 Lake Boone Trail Ste 502, Raleigh, NC 27607
CLIA data matches this NPI record on: Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RALEIGH OB/GYN CENTRE, PA
Specialist
4414 LAKE BOONE TRL, SUITE 405
RALEIGH, NC 27607
Wake County (919) 875-8225
DR. MYRA LYNN TEASLEY M.D.
Specialist
4414 LAKE BOONE TRL, SUITE 300
RALEIGH, NC 27607
Wake County (919) 781-5510
SACHIN S MUDVARI MD
Ophthalmology (Retina Specialist)
4414 LAKE BOONE TRL, SUITE 302
RALEIGH, NC 27607
Wake County (919) 782-8038
STOCKS SURGICAL CENTER, PLLC
Specialist
4414 LAKE BOONE TRL, SUITE 309
RALEIGH, NC 27607
Wake County (919) 850-0880
ERIN C. BURNETTE NP
Nurse Practitioner (Family)
4414 LAKE BOONE TRL
RALEIGH, NC 27607
Wake County (919) 781-5510
NORTH RALEIGH CARDIOVASCULAR DISEASES PA
Specialist
4414 LAKE BOONE TRL, SUITE 409
RALEIGH, NC 27607
Wake County (919) 790-0130
DR. JENIFER RAE BRISCOE-BRIMMAGE MD
Obstetrics & Gynecology
4414 LAKE BOONE TRL, SUITE 405
RALEIGH, NC 27607
Wake County (919) 876-8225
MR. JAMES GLENDON TRENNER P.A.-C
Physician Assistant (Medical)
4414 LAKE BOONE TRL, SUITE 502
RALEIGH, NC 27607
Wake County (919) 875-0539

Frequently 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 Raleigh Family Practice PA's NPI number?

The NPI number for Raleigh Family Practice PA is 1063571040. It was assigned to this organization in the NPPES registry on December 6, 2006.

Where is Raleigh Family Practice PA located?

Raleigh Family Practice PA is located at 4414 Lake Boone Trl Suite 502, Raleigh, NC 27607. The listed phone number is (919) 875-0539.

What is Raleigh Family Practice PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Raleigh Family Practice PA hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 34D0953471) is associated with this NPI, valid through September 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Raleigh Family Practice PA was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.