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VITALITY MEDICAL PLLC
NPI 1588389779
Nurse Practitioner - Family in Decatur, TX

Active since October 10, 2022
215 WESTSIDE DR STE 200, DECATUR, TX 76234(940) 273-5700(940) 273-5699 Get Directions Write a Review

NPPES record last updated: October 31, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 31, 2023, Oct 10, 2022 (2 updates tracked since 2022).

About Vitality Medical Pllc NPPES

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

VITALITY MEDICAL PLLC (NPI 1588389779) is a healthcare organization registered as a family in Decatur, Texas and active in the NPI registry since October 2022. The organization lists Courtney Danielle Jones, Fnp, as its authorized official.

NPPES Registry Identity

NPI1588389779
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameVITALITY MEDICAL PLLC
Location Address215 WESTSIDE DR STE 200Decatur, TX 76234-3869
Mailing Address215 Westside Dr Ste 200Decatur, TX 76234-3869 · (940) 273-5700 · Fax (940) 273-5699
Phone(940) 273-5700
Fax(940) 273-5699
Organization SubpartNo
Authorized OfficialCourtney Danielle JonesFnp · (940) 389-4180
Enumeration DateOctober 10, 2022
Last NPPES UpdateOctober 31, 20232 updates tracked since enumeration
NPPES CertifiedOctober 31, 2023
✔ NPI 1588389779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
215 WESTSIDE DR STE 200, Decatur, TX 76234
Open in Google Maps ↗

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vitality Medical Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Vitality Medical PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Jennifer Clark, NP
Nurse Practitioner
NPI 1295319374
215 WESTSIDE DR STE 200
Decatur, TX 76234
(940) 273-5700
✔ PECOS✔ Accepts MedicareSame address
Courtney Jones, APRN
Nurse Practitioner
NPI 1356910640
215 WESTSIDE DR STE 200
Decatur, TX 76234
(940) 732-5700
✔ PECOS✔ Accepts MedicareSame address
Camerin Dyson, APRN, FNP-BC
Nurse Practitioner
NPI 1679226617
306 FRANKLIN RD
Eddy, TX 76524
(940) 366-1100
✔ PECOS✔ Accepts Medicare137 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Waiver 45D2270122

Vitality Medical · Decatur, TX
Expired · Oct 9, 2026
CLIA Number45D2270122
Laboratory TypePhysician Office
Certificate Effective DateOctober 10, 2024
Certificate Expiration DateOctober 9, 2026
Laboratory DirectorCourtney Jones
Laboratory Phone(940) 273-5700
Laboratory LocationVitality Medical215 Westside Dr Suite 200, Decatur, TX 76234
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Vitality Medical PLLC's NPI number?

The NPI number for Vitality Medical PLLC is 1588389779. It was assigned to this organization in the NPPES registry on October 10, 2022.

Where is Vitality Medical PLLC located?

Vitality Medical PLLC is located at 215 Westside Dr Ste 200, Decatur, TX 76234. The listed phone number is (940) 273-5700.

What is Vitality Medical PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Vitality Medical PLLC enrolled in Medicare?

Yes. Vitality Medical PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Vitality Medical PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Vitality Medical PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Vitality Medical PLLC accept?

Health plans from Molina Healthcare list Vitality Medical PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Vitality Medical PLLC was last updated on October 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.