Advance Community Health, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Fuquay Varina, NC
NPI 1114913092 · NPPES record last updated Jul 16, 2026
Key facts
- NPI
- 1114913092
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- ADVANCE COMMUNITY HEALTH, INC
- Practice address
- 130 N Judd Pkwy NE
Fuquay Varina, NC 27526-2367 - Phone
- (919) 557-1110
- Fax
- (919) 557-1102
- NPI assigned
- Sep 26, 2005
- Organization subpart
- No
Authorized official
- Name
- Scot McCray
- Title
- Chief Executive Officer
- Phone
- (856) 449-4068
Other NPIs on the same Medicare enrollment 13
Other NPIs with the same Medicare PAC ID 7
Practitioners 68
-
Ziad Chahine El Tannir, PA-C
-
Aries Hamlet, PA-C
-
Deanna Harris, MD
-
Victoria Lynn Harris, PA-C
-
Jessica Reid, FNP
-
Melody Washington, MSW, LCSWA
-
Fanteema Barnes, LCSW
-
Lauren Maria Boulus, MS, RD, LDN
-
Sheila De Leon Cabalu, DNP, APRN, FNP-C
-
Robert Thomas Dodge, PHD, RN, ANP
-
Christa Martina Fleming, PA-C
-
Heidi Marie Hughes, FNP-C
-
Bryiane Pascua Medina, FNP-BC
-
Stephanie Rodman-Agbejule, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC
Federally qualified health center certification: CCN 341864
- Legal name
- ADVANCE COMMUNITY HEALTH INC
- Doing business as
- ADVANCE COMMUNITY HEALTH
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Sep 12, 2001
- Last certification
- Sep 12, 2001
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 11, 1972 in NC
- Enrollment address
- 130 N Judd Pkwy NE
Fuquay Varina, NC 27526-2367
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Scot McCray |
Corporate Officer |
Feb 1, 2021 | |
| W-2 Managing Employee |
Feb 1, 2021 | ||
| Operational/Managerial Control |
Feb 1, 2021 | ||
| Desiree Bolling |
Corporate Director |
Jun 22, 2020 | |
| Tara N Minter |
Corporate Director |
Dec 17, 2017 | |
| Parris Solomon |
Corporate Director |
Apr 26, 2021 | |
| Alecia Smith Taylor |
Corporate Director |
Jan 27, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
| O20111209000221 | NC | Part a Provider - Federally Qualified Health Center (FQHC) | 3577471697 | Practice locations: Fuquay Varina, NC |
National Provider Directory
Locations
618 W Jones St
Ste 102
Raleigh, NC 27603
Phone (919) 755-1888
102 N Tarboro St
Raleigh, NC 27610
Phone (919) 743-3315
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
130 N Judd Pkwy NE
Fuquay Varina, NC 27526-2367
Mailing address
1001 Rock Quarry Rd
Raleigh, NC 27610-3825
Phone (919) 833-3111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 344589A | Medicaid | NC |
Other names
- Advance Community Health
- Amplify Health
Other providers in Fuquay Varina, NC
- A Good Mind Counseling, PLLC
- Rebecca Michelle Acevedo
- Shrija Acharya
- Corin Leigh Adams
- Jamie-Sue Adams
- Advance Community Health, Inc
- Grant Charles Agar
- Latonya L Agard
- Agilias USA, Inc
- Agilitas USA, Inc
All providers in Fuquay Varina, NC · Federally Qualified Health Center (FQHC) in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.