PNC Group LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

PNC GROUP LLC

Doing business as

Advanced Care Home Plus

Practice address

5501 E Polo Dr
Wichita, KS 67208-2753

Phone

(316) 806-9242

NPI assigned

Mar 28, 2023

Last updated

Mar 28, 2023By 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

Derek S Hammond

Title

Owner

Phone

(316) 806-9242

Specialties & licenses 2

Addresses

Other names 1

• Advanced Care Home Plus Doing business as

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1093419764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 E POLO DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672082753",
            "telephone_number": "316-806-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 E POLO DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672082753",
            "telephone_number": "316-806-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PNC GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-806-9242"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Care Home Plus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Wichita, KS
• Providers in Wichita, KS by specialty
• Adult Care Home Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.