NPIMap

Organization Active NPI

Advance Community Health, Inc

Doing business as Amplify Health

  • Federally Qualified Health Center (FQHC)
  • Raleigh, NC
National Provider Identifier
1114479011
Registry record updated Jul 16, 2026
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
Doing business as
Amplify Health
Practice address
1430 S Wilmington St
Raleigh, NC 27603-2526
Phone
(919) 833-3111
Fax
(919) 834-3118
NPI assigned
Oct 27, 2016
Last updated
Jul 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Authorized official

Name
Scot McCray
Title
Ceo
Phone
(919) 833-3111

Specialties & licenses 1

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

Addresses

Primary practice location

1430 S Wilmington St
Raleigh, NC 27603-2526

Mailing address

1001 Rock Quarry Rd
Raleigh, NC 27610-3825
Phone (919) 250-2934

Other names 1

  • Amplify Health Doing business as

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
O20170113000078 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 1114479011. Details of each certification follow.

Federally qualified health center certification: CCN 341055

Legal name
ADVANCE COMMUNITY HEALTH INC
Doing business as
ADVANCE COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 3, 2017
Last certification
Feb 3, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 11, 1972 in NC
Enrollment address
1430 S Wilmington St
Raleigh, NC 27603-2526

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

National Provider Directory

National Provider Directory

Locations

111 S Church St
Louisburg, NC 27549
Phone (919) 250-2923

1430 S Wilmington St
Raleigh, NC 27603

Ownership & related parties

All disclosed owners & managing parties 5

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 OfficerCeo Feb 1, 2021
W-2 Managing EmployeeCeo Feb 1, 2021
Operational/Managerial ControlCeo Feb 1, 2021
Tara N Minter Individual Corporate DirectorBoard Member Dec 17, 2017
James W Teagle Individual Corporate OfficerTreasurer Jan 1, 2019
Corporate DirectorBoard Member Jun 27, 2011
Acie L Ward Individual Corporate OfficerVice Chair Jun 21, 2012
Laura Emerson Edwards Individual Corporate DirectorBoard Member Mar 28, 2016

Practitioners & affiliated clinicians

Practitioners 6

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": "1477526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1114479011",
    "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": "919-250-2934",
            "fax_number": "919-573-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 S WILMINGTON ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276032526",
            "telephone_number": "919-833-3111",
            "fax_number": "919-834-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE COMMUNITY HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-27",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A",
        "authorized_official_last_name": "MCCRAY",
        "authorized_official_first_name": "SCOT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-833-3111"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amplify Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.