NPIMap

Organization Active NPI

Advanced Health Care Management Services, LLC

Doing business as Advanced Healthcare Medical Center

  • Critical Access Hospital
  • Ellington, MO
National Provider Identifier
1285690644
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
459-5 Issued in MO
Legal business name
ADVANCED HEALTH CARE MANAGEMENT SERVICES, LLC
Doing business as
Advanced Healthcare Medical Center
Practice address
100 Highway 21 N
Ellington, MO 63638-9409
Phone
(573) 663-2511
Fax
(573) 663-2815
NPI assigned
Apr 25, 2006
Reactivated
Jul 30, 2013
Last updated
Jul 30, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANCED HEALTH CARE MANAGEMENT SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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

Authorized official

Name
Paula E. Harris
Title
Chief Executive Officer
Phone
(573) 778-0020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 459-5 MO Primary

Addresses

Primary practice location

100 Highway 21 N
Ellington, MO 63638-9409

Mailing address

PO Box 989
Poplar Bluff, MO 63902-0989
Phone (573) 778-0020

Other identifiers 1

IdentifierTypeStateIssuer
010323707MedicaidMO

Other names 1

  • Advanced Healthcare Medical Center Doing business as

National Provider Directory

National Provider Directory
Part of
Adv Healthcare MGNT SVS LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375142400000",
    "number": "1285690644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 989",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639020989",
            "telephone_number": "573-778-0020",
            "fax_number": "573-776-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHWAY 21 N",
            "city": "ELLINGTON",
            "state": "MO",
            "postal_code": "636389409",
            "telephone_number": "573-663-2511",
            "fax_number": "573-663-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEALTH CARE MANAGEMENT SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED HEALTH CARE MANAGEMENT SERVICES, LLC",
        "enumeration_date": "2006-04-25",
        "last_updated": "2013-07-30",
        "deactivation_date": "2013-02-06",
        "reactivation_date": "2013-07-30",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "573-778-0020"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MO",
            "license": "459-5",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010323707",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Healthcare Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.