Advantage Family Care, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101228019 Issued in VA

Legal business name

ADVANTAGE FAMILY CARE, P.C.

Practice address

3105 American Legion Rd Ste a
Chesapeake, VA 23321-5653

Phone

(757) 686-3999

Fax

(757) 686-3015

NPI assigned

Feb 18, 2009

Last updated

Jan 10, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Latanya Gray, MD

Title

President

Phone

(757) 686-3999

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1073752838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 AMERICAN LEGION RD STE A",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215653",
            "telephone_number": "757-686-3999",
            "fax_number": "757-686-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 AMERICAN LEGION RD STE A",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215653",
            "telephone_number": "757-686-3999",
            "fax_number": "757-686-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE FAMILY CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-18",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "LATANYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-686-3999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101228019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5641420",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.