Indvanced Medicine Associates PA

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

INDVANCED MEDICINE ASSOCIATES PA

Practice address

1145 19TH Street NW
Suite 702
Washington, DC 20036

Phone

(877) 358-8648

Fax

(877) 877-6875

NPI assigned

Mar 11, 2025

Organization subpart

No

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

Authorized official

Name

Juana Slack

Title

Medical Billing Specialist

Phone

(480) 646-9086

Specialties & licenses 1

Addresses

Other names 1

• Passport Health Doing business as

Tax ID family

Passport Health Holdings LLC218 organizations share this tax ID, including this one

Locations

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782345600000",
    "number": "1306645387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 EAST OUTLIER BLVD.",
            "address_2": "SUITE 100W",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086507",
            "telephone_number": "877-358-8648",
            "fax_number": "877-877-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 19TH STREET NW",
            "address_2": "SUITE 702",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20036",
            "telephone_number": "877-358-8648",
            "fax_number": "877-877-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDVANCED MEDICINE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-11",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A",
        "authorized_official_last_name": "SLACK",
        "authorized_official_first_name": "JUANA",
        "authorized_official_title_or_position": "MEDICAL BILLING SPECIALIST",
        "authorized_official_telephone_number": "480-646-9086"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Passport Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Health Worker in Washington, DC
• Providers in Washington, DC by specialty
• Community Health Worker in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.