NPIMap

Organization Active NPI

Advance Community Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Raleigh, NC
National Provider Identifier
1003528381
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ADVANCE COMMUNITY HEALTH, INC
Practice address
1315 Oakwood Ave
Raleigh, NC 27610-2247
Phone
(919) 833-3111
NPI assigned
Dec 19, 2022
Last updated
Jan 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Authorized official

Name
Scot McCray
Title
Chief Executive Officer
Phone
(919) 833-3111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1315 Oakwood Ave
Raleigh, NC 27610-2247

Mailing address

1001 Rock Quarry Rd
Raleigh, NC 27610-3825
Phone (919) 250-2923

Other names 1

  • St. Augustine University CarePlex Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://advancechc.org/contact-us/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040824000695 NC Part B Supplier - Clinic/Group Practice 3577471697 Receives reassigned benefits from 91 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wendell, NC; Wake Forest, NC; Raleigh, NC; Louisburg, NC; Apex, NC; Cary, NC; Holly Springs, NC; Fuquay Varina, NC
O20241108003357 NC Part A Provider - Federally Qualified Health Center (FQHC) 3577471697 Practice locations: Raleigh, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003528381. Details of each certification follow.

Federally qualified health center certification: CCN B61059

Legal name
ADVANCE COMMUNITY HEALTH INC
Doing business as
ST. AUGUSTINE UNIVERSITY CAREPLEX
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 15, 2024
Last certification
Nov 15, 2024
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Apr 20, 1972 in NC
Enrollment address
1315 Oakwood Ave
Raleigh, NC 27610-2247

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2281936Advance Community Health -St Augustine1315 Oakwood Avenue, Raleigh, NC 27610Certificate of waiverMay 14, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Scot McCray Individual Corporate OfficerChief Executive Officer Feb 1, 2021
Tonchelle Renee Lucas Individual W-2 Managing EmployeeCredentialing Manager May 15, 2017

NPI Registry JSON

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1003528381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ROCK QUARRY RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276103825",
            "telephone_number": "919-250-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 OAKWOOD AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276102247",
            "telephone_number": "919-833-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE COMMUNITY HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-19",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "MCCRAY",
        "authorized_official_first_name": "SCOT",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "919-833-3111"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://advancechc.org/contact-us/",
            "affiliation": "N",
            "address_1": "1315 Oakwood Ave",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276102247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "St. Augustine University CarePlex",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.