| Vitacore LLC | |
|
340 Commerce Ave Ste 4-5 Southern Pines NC 28387-7093 | |
| (910) 690-6894 | |
| (910) 227-3739 |
| Full Name | Vitacore LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 340 Commerce Ave Ste 4-5, Southern Pines, North Carolina |
| Authorized Official Name and Position | Philip Mondi (OWNER) |
| Authorized Official Contact | 9106906894 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitacore LLC 340 Commerce Ave Ste 4-5 Southern Pines NC 28387-7093 Ph: (910) 690-6894 | Vitacore LLC 340 Commerce Ave Ste 4-5 Southern Pines NC 28387-7093 Ph: (910) 690-6894 |
| NPI Number | 1639987431 |
|---|---|
| Provider Enumeration Date | 12/26/2024 |
| Last Update Date | 07/20/2026 |
| Certification Date | 07/20/2026 |
| Medicare PECOS PAC ID | 8527589464 |
|---|---|
| Medicare Enrollment ID | O20250306003827 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639987431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 363A00000X | Physician Assistant | () | Secondary |
| 363L00000X | Nurse Practitioner | () | Secondary |
| Provider Name | Angela M Walling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679508253 PECOS PAC ID: 3577508019 Enrollment ID: I20050624000210 |
| Provider Name | Philip G Mondi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316982580 PECOS PAC ID: 9931105806 Enrollment ID: I20100322000334 |
| Provider Name | Kayla Rose Keegan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861030165 PECOS PAC ID: 8527496017 Enrollment ID: I20200316002234 |
| Provider Name | Constance Marie Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679046320 PECOS PAC ID: 2466881685 Enrollment ID: I20201229000778 |
Thrive Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 760c Nw Broad St, Southern Pines, NC 28387 Phone: 916-431-0236 |
Walter S Morris III MD PLLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 390 Sw Broad St, Unit A, Southern Pines, NC 28387 Phone: 910-639-2583 |
Family Care Plus Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 630 S Bennett Street, Southern Pines, NC 28384 Phone: 910-693-1678 Fax: 910-693-1612 |
Thrive Health & Wellness, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 760c Nw Broad St, Southern Pines, NC 28387 Phone: 916-431-0236 Fax: 916-431-0236 |
Randall Robert Mercier PA Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 630 S Bennett St, Southern Pines, NC 28387 Phone: 910-692-0873 Fax: 910-295-1787 |
Firsthealth Concierge Signature Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1690 Us Highway 1 S Ste 300, Southern Pines, NC 28387 Phone: 910-684-5499 Fax: 910-684-5567 |