NPIMap

Organization Active NPI

Advanced Healthcare

  • Family Medicine Physician
  • Mooresville, NC
National Provider Identifier
1124084702
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVANCED HEALTHCARE
Practice address
191A W Plaza Dr
Mooresville, NC 28117-6806
Phone
(704) 664-4000
Fax
(704) 660-5251
NPI assigned
Apr 24, 2006
Last updated
Oct 31, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Authorized official

Name
Dr. Emmett Fulcher Montgomery, MDNPI 1356337646
Title
Owner/Family Practice Physician
Phone
(704) 664-4000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

191A W Plaza Dr
Mooresville, NC 28117-6806

Mailing address

191A W Plaza Dr
Mooresville, NC 28117-6806
Phone (704) 664-4000

National Provider Directory

National Provider Directory

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": "1145836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1124084702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191A W PLAZA DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176806",
            "telephone_number": "704-664-4000",
            "fax_number": "704-660-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191A W PLAZA DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176806",
            "telephone_number": "704-664-4000",
            "fax_number": "704-660-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-24",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "EMMETT",
        "authorized_official_middle_name": "FULCHER",
        "authorized_official_title_or_position": "OWNER/FAMILY PRACTICE PHYSICIAN",
        "authorized_official_telephone_number": "704-664-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.