Advance Medical Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ADVANCE MEDICAL CLINIC

Practice address

103 South Oak Street
Advance, MO 63730

Phone

(573) 722-3467

Fax

(573) 722-3469

NPI assigned

Jun 9, 2008

Last updated

May 24, 2012By 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

Ms. Lori Ann Williams, FNP-BC

Title

Owner

Phone

(573) 722-3467

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1265691869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669",
            "address_2": "103 SOUTH OAK STREET",
            "city": "ADVANCE",
            "state": "MO",
            "postal_code": "637300669",
            "telephone_number": "573-722-3467",
            "fax_number": "573-722-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SOUTH OAK STREET",
            "city": "ADVANCE",
            "state": "MO",
            "postal_code": "63730",
            "telephone_number": "573-722-3467",
            "fax_number": "573-722-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-722-3467",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advance Missouri Health Care (Advance Assisted Living)
• Advance R-IV Public Schools
• Aspire Senior Living Advance, LLC (Aspire Senior Living Advance)
• John Backfisch, LPC
• Kimberly Backfisch, LPC, RPT

• Clinic/Center in Advance, MO
• Providers in Advance, MO by specialty
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.