VITALITY MEDICAL
NPI 1962930503
Clinic/Center - Primary Care in Sallisaw, OK

NPI Status: Active since May 26, 2017

Contact Information

209 N OAK ST
SALLISAW, OK
ZIP 74955
Phone: (918) 636-3930
Fax: (888) 422-2115

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  • Organization
  • Clinic/Center
  • Primary Care
  • CLIA Number: 37D2133295
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 07-09-2027

About VITALITY MEDICAL

This page provides the complete NPI Profile along with additional information for Vitality Medical, a primary care provider established in Sallisaw, Oklahoma operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1962930503 assigned on May 2017. The practitioner's primary taxonomy code is 261QP2300X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Niko Koliastasis (Ceo)

NPI
1962930503
Provider Name
VITALITY MEDICAL
Entity Type
Organization
Location Address
209 N OAK ST SALLISAW, OK 74955
Location Phone
(918) 636-3930
Location Fax
(888) 422-2115
Mailing Address
209 N OAK ST SALLISAW, OK 74955
Mailing Phone
(918) 503-6276
Mailing Fax
(888) 422-2115
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-26-2017
Last Update Date
01-08-2020
Code Navigator

A primary care provider (PCP) like Vitality Medical sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Primary Care

Taxonomy Code
261QP2300X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

NIKO KOLIASTASIS

Authorized Official Title
CEO
Authorized Official Phone
(918) 636-3930

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
37D2133295
Facility Type
Physician Office
Certificate Effective Date
July 10, 2025
Certificate Expiration Date
July 09, 2027
Laboratory Director
JASON T. STANSILL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Vitality Medical to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1962930503, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
2
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
3
Unchanged
Pos 7
0
Doubled → 0
Pos 8
5
Unchanged
Pos 9
0
Doubled → 0
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 9 → 18 → 9 0 → 0 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 1 + 2 + 2 + 1 + 8 + 3 + 0 + 5 + 0 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1962930503.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Clinic/Center (Primary Care)
209 N OAK ST
SALLISAW, OK 74955

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1962930503, enumerated as an "organization" on May 26, 2017.

The provider is located at 209 N OAK ST SALLISAW, OK 74955 and the phone number is (918) 636-3930.

Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.