Advantage Primary Care

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

ADVANTAGE PRIMARY CARE

Practice address

7605 Forest Ave Ste 412
Richmond, VA 23229-4941

Phone

(804) 381-6252

NPI assigned

Aug 23, 2022

Last updated

Aug 23, 2022By 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

Mr. James DetrickNPI 1346273869

Title

Owner

Phone

(804) 381-6252

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• James Detrick

  • Physician Assistant
  • Midlothian, VA
  • NPI 1346273869
  Medicare reassignment Authorized official
• Michele Hodges, NP

  • Primary Care Nurse Practitioner
  • Richmond, VA
  • NPI 1962061101
  Medicare reassignment NPD

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1245959287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7605 FOREST AVE STE 412",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232294941",
            "telephone_number": "804-381-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7605 FOREST AVE STE 412",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232294941",
            "telephone_number": "804-381-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "DETRICK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-381-6252",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced Otolaryngology PC
• Advanced Services for Kids, LLC
• Advanced Technologies in Home Care (AT Home Care Staffing)
• Advanced Technologies in Home Care, Inc. (AT Home Care, Inc.)
• Advanta Wellness
• Aegis Group Practice LLC
• Aesthetic Dermatology & Surgery Clinique, Inc (West End Dermatology Associates)
• Aevum Behavioral Health VA LLC (Aevum Behavioral Health)
• Aevum BH VA LLC (Aevum Behavioral Health)
• Affiliated Fan Podiatry PC

• Physician Assistant in Richmond, VA
• Providers in Richmond, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.