Organization Active NPI

Advanced Practice and Wellness LLC

  • Family Medicine Physician
  • Orange City, FL
National Provider Identifier
1003656919
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVANCED PRACTICE AND WELLNESS LLC
Practice address
2425 S Volusia Ave Ste B3
Orange City, FL 32763-7625
Phone
(386) 473-7005
Fax
(386) 473-7006
NPI assigned
May 29, 2024
Last updated
Oct 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Authorized official

Name
Gregory Wade PrinceNPI 1043826688
Title
Co-Owner
Phone
(256) 612-0173

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X
Family Medicine Physician 207Q00000X Primary
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

2425 S Volusia Ave Ste B3
Orange City, FL 32763-7625

Mailing address

2425 S Volusia Ave Ste B3
Orange City, FL 32763-7625
Phone (386) 473-7005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250829000903 FL Part B Supplier - Clinic/Group Practice 7810498052 Receives reassigned benefits from 1 practitioner
Practice locations: Orange City, FL

National Provider Directory

National Provider Directory

Locations

2425 S Volusia Ave
Ste B3
Orange City, FL 32763
Phone (386) 218-3145

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IJFIDD

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1003656919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 S VOLUSIA AVE STE B3",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637625",
            "telephone_number": "386-473-7005",
            "fax_number": "386-473-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 S VOLUSIA AVE STE B3",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637625",
            "telephone_number": "386-473-7005",
            "fax_number": "386-473-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PRACTICE AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "256-612-0173"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.