Advanced Internal Medicine LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

01045818 Issued in IN

Legal business name

ADVANCED INTERNAL MEDICINE LLC

Practice address

302 N Duke St
Peru, IN 46970-1520

Phone

(765) 472-3944

Fax

(765) 472-3945

NPI assigned

Mar 16, 2010

Last updated

Nov 19, 2013By 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. Gregory A Quin, MDNPI 1548260714

Title

Owner

Phone

(765) 472-3944

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

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.

• Gregory A Quin, MD

  • Legal Medicine
  • Peru, IN
  • NPI 1548260714
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384819200000",
    "number": "1124342407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 N DUKE ST",
            "address_2": "P.O. BOX 368",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469701520",
            "telephone_number": "765-472-3944",
            "fax_number": "765-472-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 N DUKE ST",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469701520",
            "telephone_number": "765-472-3944",
            "fax_number": "765-472-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-16",
        "last_updated": "2013-11-19",
        "status": "A",
        "authorized_official_last_name": "QUIN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-472-3944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IN",
            "license": "01045818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200131050",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 41 Health Collective LLC
• Anbrea Adams
• Advanced Integrative Medicine and Chiropractice Wellness Center PC
• Joline Alexander, M.A., CCC-SLP
• Alliance Healthcare Services Inc
• Allied Physicians Inc., D/B/a Tri-State Physical Medicine
• Linda L Allison, OTR
• Olivia Alvarado

• Primary Care Clinic/Center in Peru, IN
• Providers in Peru, IN by specialty
• Primary Care Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.