NPIMap

Organization Active NPI

Advanced Senior Care of Missouri Inc

Doing business as Advanced Senior Care

  • Internal Medicine Physician
  • Columbia, MO
National Provider Identifier
1245087295
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ADVANCED SENIOR CARE OF MISSOURI INC
Doing business as
Advanced Senior Care
Practice address
910 N College Ave Ste 4
Columbia, MO 65201-4797
Phone
(636) 642-1215
Fax
(573) 234-4799
NPI assigned
May 6, 2024
Last updated
Nov 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Bradley Beaird
Title
Owner
Phone
(636) 642-1215

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

910 N College Ave Ste 4
Columbia, MO 65201-4797

Mailing address

910 N College Ave Ste 4
Columbia, MO 65201-4797
Phone (636) 642-1215

Other names 1

  • Advanced Senior Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240613000443 MO Part B Supplier - Clinic/Group Practice 1052853421 Receives reassigned benefits from 10 practitioners
Practice locations: Columbia, MO; Mexico, MO; Eldon, MO; Fulton, MO; Glasgow, MO; Holts Summit, MO; Jefferson City, MO; Marshall, MO…

National Provider Directory

National Provider Directory

Locations

109 N Keene St
Columbia, MO 65201
Phone (573) 443-2007

619 E 8th St
Eldon, MO 65026
Phone (573) 557-9545

Practitioners & affiliated clinicians

Practitioners 12

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": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1245087295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 N COLLEGE AVE STE 4",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652014797",
            "telephone_number": "636-642-1215",
            "fax_number": "573-234-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 N COLLEGE AVE STE 4",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652014797",
            "telephone_number": "636-642-1215",
            "fax_number": "573-234-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SENIOR CARE OF MISSOURI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "BEAIRD",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-642-1215"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Senior Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Senior Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.