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VITA FAMILY PRACTICE PLLC
NPI 1770004723
Clinic/Center - Primary Care in Fayetteville, NC

Active since June 29, 2017CLIA 34D2133177 · Waiver
609 EXECUTIVE PL STE B, FAYETTEVILLE, NC 28305(910) 489-3185 Get Directions Write a Review

NPPES record last updated: January 31, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Vita Family Practice Pllc NPPES

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

VITA FAMILY PRACTICE PLLC (NPI 1770004723) is a healthcare organization registered as a primary care in Fayetteville, North Carolina and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through July 6, 2027 and lists Jennifer I Sturcken, Owner, as its authorized official.

NPPES Registry Identity

NPI1770004723
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameVITA FAMILY PRACTICE PLLC
Location Address609 EXECUTIVE PL STE BFayetteville, NC 28305-5713
Mailing Address609 Executive Pl Ste BFayetteville, NC 28305-5713 · (910) 677-9488 · Fax (866) 694-9185
Phone(910) 489-3185
Organization SubpartNo
Authorized OfficialJennifer I SturckenOwner · (910) 677-9488
Enumeration DateJune 29, 2017
Last NPPES UpdateJanuary 31, 2024
NPPES CertifiedJanuary 31, 2024
✔ NPI 1770004723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
609 EXECUTIVE PL STE B, Fayetteville, NC 28305
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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 34D2133177

Vita Family Practice, PLLC · Fayetteville, NC
Active · expires Jul 6, 2027
CLIA Number34D2133177
Laboratory TypePhysician Office
Certificate Effective DateJuly 7, 2025
Certificate Expiration DateJuly 6, 2027
Laboratory DirectorRebecca A. Calhoun
Laboratory Phone(910) 257-7947
Laboratory LocationVita Family Practice, PLLC609 - B Executive Place, Fayetteville, NC 28305
CLIA data matches this NPI record on: Name
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 Vita Family Practice PLLC's NPI number?

The NPI number for Vita Family Practice PLLC is 1770004723. It was assigned to this organization in the NPPES registry on June 29, 2017.

Where is Vita Family Practice PLLC located?

Vita Family Practice PLLC is located at 609 Executive Pl Ste B, Fayetteville, NC 28305. The listed phone number is (910) 489-3185.

What is Vita Family Practice PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Vita Family Practice PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2133177) is associated with this NPI, valid through July 6, 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 Vita Family Practice PLLC was last updated on January 31, 2024. 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.