Advance Care Medical PCP Tennessee

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ADVANCE CARE MEDICAL PCP TENNESSEE

Practice address

1469 Tiny Town Rd
Clarksville, TN 37042-7202

Phone

(516) 801-1552

NPI assigned

Jul 13, 2021

Organization subpart

No

Name

Douglas Millar

Title

Senior Advisor

Phone

(917) 673-6321

• Advance Care Medical Clarksville TN Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 11, 2022.

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1164094819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SCHOOL ST STE 303",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422548",
            "telephone_number": "516-801-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1469 TINY TOWN RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370427202",
            "telephone_number": "516-801-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE CARE MEDICAL PCP TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-13",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "MILLAR",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "SENIOR ADVISOR",
        "authorized_official_telephone_number": "917-673-6321"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advance Care Medical Clarksville TN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie M Adcock, BCBA, LBA
• Timothy Wells Adcock, CRNA
• Addiction & Mental Health Services, LLC
• Megan Adkins
• Brian A Adrian, M.D.
• Advance Care Medical Tennessee, Inc.
• Advanced Behavior Consultants
• Advanced Diagnostic Imaging PC
• Advanced Diagnostic Imaging, PC
• Advanced Diagnostic Imaging, PC

• All providers in Clarksville, TN
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.