Avalon Advanced Health, PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

05-32944 Issued in KS

Legal business name

AVALON ADVANCED HEALTH, PA

Practice address

1011 W 27TH St
Suite F4
Hays, KS 67601-4823

Phone

(785) 301-2639

NPI assigned

May 5, 2015

Last updated

Aug 12, 2015By 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. Marshall Eidenberg, D.O.

Title

Vice President/Cmo

Phone

(785) 301-2639

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439337600000",
    "number": "1245617646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W 27TH ST",
            "address_2": "SUITE F4",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676014823",
            "telephone_number": "785-301-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W 27TH ST",
            "address_2": "SUITE F4",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676014823",
            "telephone_number": "785-301-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON ADVANCED HEALTH, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-08-12",
        "status": "A",
        "authorized_official_last_name": "EIDENBERG",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_title_or_position": "VICE PRESIDENT/CMO",
        "authorized_official_telephone_number": "785-301-2639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "KS",
            "license": "05-32944",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "05-32944",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara R Aschenbrenner
• Patrick Scott Atkinson, D.O.
• Rachel Lindsey Atkinson, DPT
• Leanna Lynn Atterbury, PA-C
• Lindsey Beth Augustine, DC
• Avantgarde, LLC
• Faris Sabri Azzouni, MD
• Mirza Baig, M.D.
• Rylie J Bailey
• Michael Riley Barrett, ATC

• Clinic/Center in Hays, KS
• Providers in Hays, KS by specialty
• Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.