Neoteric Vitality Primary Care and Aesthetics

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NEOTERIC VITALITY PRIMARY CARE AND AESTHETICS

Practice address

601 Tower LN Ste 100
Middletown, DE 19709-1763

Phone

(302) 374-0308

Fax

(302) 204-6306

NPI assigned

Nov 18, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Janika Wallace, DONPI 1255642930

Title

Owner/Physician

Phone

(302) 374-0308

Specialties & licenses 1

Addresses

Other names 1

• Neoteric Vitality Primary Care Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Janika Inez Wallace, D.O.

  • Family Medicine Physician
  • Middletown, DE
  • NPI 1255642930
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1528928835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 TOWER LN STE 100",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091763",
            "telephone_number": "302-374-0308",
            "fax_number": "302-204-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 TOWER LN STE 100",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091763",
            "telephone_number": "302-374-0308",
            "fax_number": "302-204-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOTERIC VITALITY PRIMARY CARE AND AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "JANIKA",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "302-374-0308",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neoteric Vitality Primary Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Family Medicine Physician in Middletown, DE
• Providers in Middletown, DE by specialty
• Family Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.