Advanced Healthcare Associates, LLC
Organization Active NPI Family Nurse Practitioner · Fredonia, KS
NPI 1194451526 · NPPES record last updated Jul 28, 2022
Key facts
- NPI
- 1194451526
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- ADVANCED HEALTHCARE ASSOCIATES, LLC
- Practice address
- 928 N 3Rd St
Fredonia, KS 66736-2166 - Phone
- (620) 288-1030
- NPI assigned
- Jul 27, 2022
- Organization subpart
- No
Authorized official
- Name
- Mrs. Lindsay Lee Forrester, APRN
- Title
- Co-Owner, Aprn
- Phone
- (620) 288-1030
Practitioners 4
-
Lindsay L Forrester, APRN
-
Jessica L Evans, NP
-
Britni Dawn Stewart, APRN-C
-
Sarah Renee Baker, NP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D2266533 | Advanced Healthcare Associates, LLC | Certificate of waiver | Aug 10, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220928000678 | KS | Part B Supplier - Clinic/Group Practice | 0547646614 |
Receives reassigned benefits from 4 practitioners Practice locations: Fredonia, KS |
National Provider Directory
Locations
928 N 3rd St
Fredonia, KS 66736
Phone (620) 288-1030
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
928 N 3Rd St
Fredonia, KS 66736-2166
Mailing address
928 N 3Rd St
Fredonia, KS 66736-2166
Phone (620) 288-1030
Other providers in Fredonia, KS
- Ambrosio P Mendiola MD LLC
- Oswaldo Cruz Bacani Sr.
- Koralyn Dawn Barkman
- James E Clay
- Ronald Guy Cleverley
All providers in Fredonia, KS · Family Nurse Practitioner in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2022. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.