NPIMap

Organization Active NPI

Advanced Family Healthcare LLC

  • Clinic/Center
  • Hastings, NE
National Provider Identifier
1285359000
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ADVANCED FAMILY HEALTHCARE LLC
Practice address
926 E E St
Hastings, NE 68901-6617
Phone
(402) 303-8802
Fax
(402) 487-0599
NPI assigned
Oct 4, 2022
Last updated
Dec 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Authorized official

Name
Tamaka K GangwishNPI 1669844916
Title
Aprn
Phone
(402) 303-8802

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

926 E E St
Hastings, NE 68901-6617

Mailing address

926 East 'E' St
Hastings, NE 68901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221227000106 NE Part B Supplier - Clinic/Group Practice 6103296777 Receives reassigned benefits from 5 practitioners
Practice locations: Hastings, NE

National Provider Directory

National Provider Directory

Locations

926 E E St
Hastings, NE 68901
Phone (402) 463-3181

926 E E St
Ste 100
Hastings, NE 68901
Phone (402) 303-8802

Practitioners & affiliated clinicians

Practitioners 5

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": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1285359000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 EAST 'E' ST",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "68901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 E E ST",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689016617",
            "telephone_number": "402-303-8802",
            "fax_number": "402-487-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FAMILY HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-04",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "GANGWISH",
        "authorized_official_first_name": "TAMAKA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "402-303-8802"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.