VITA FAMILY PRACTICE PLLC
NPI 1770004723
Clinic/Center - Primary Care in Fayetteville, NC
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Vita Family Practice Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Vita Family Practice PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 34D2133177
Vita Family Practice, PLLC · Fayetteville, NCFrequently 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.
Is Vita Family Practice PLLC enrolled in Medicare?
Yes. Vita Family Practice PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Vita Family Practice PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Emergency Medicine) reassigns their Medicare billing to Vita Family Practice 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
# Vita Family Practice Pllc · NPI 1770004723
Primary Care organization in Fayetteville, North Carolina. Organization record, active in the CMS NPPES registry since June 29, 2017.
## Identity
- **NPI:** 1770004723 (Entity type: Organization)
- **Enumerated:** June 29, 2017
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Jennifer Sturcken, OWNER
## Practice location
- **Address:** 609 EXECUTIVE PL STE B, Fayetteville, NC 28305-5713
- **Phone:** (910) 489-3185
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Emergency Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 31, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1770004723) · Data from the CMS NPPES public registry.