NPIMap

Organization Active NPI

Advanced Health Care Management Services, LLC

Doing business as Advanced Foot & Ankle Clinic

  • Podiatric Clinic/Center
  • Poplar Bluff, MO
National Provider Identifier
1306802632
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
ADVANCED HEALTH CARE MANAGEMENT SERVICES, LLC
Doing business as
Advanced Foot & Ankle Clinic
Practice address
2002 Kanell Blvd
Poplar Bluff, MO 63901-4045
Phone
(573) 785-4959
Fax
(573) 785-6405
NPI assigned
Apr 25, 2006
Last updated
Mar 9, 2012By 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 Mar 9, 2012

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
Podiatric Clinic/Center 261QP1100X NU Primary

Addresses

Primary practice location

2002 Kanell Blvd
Poplar Bluff, MO 63901-4045

Mailing address

PO Box 989
2002 Kanell Boulevard
Poplar Bluff, MO 63902-0989
Phone (573) 778-0020

Other identifiers 1

IdentifierTypeStateIssuer
302717707MedicaidMO

Other names 1

  • Advanced Foot & Ankle Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
Advanced Healthcare Management Services LLC

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

350 E Walnut St
Ellington, MO 63638
Phone (573) 546-8008

2002 Kanell Blvd
Ste 101
Poplar Bluff, MO 63901
Phone (573) 614-1900

2002 Kanell Blvd
Ste 106
Poplar Bluff, MO 63901
Phone (573) 712-2546

1009 Main St
Van Buren, MO 63965
Phone (573) 323-4812

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": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1306802632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 989",
            "address_2": "2002 KANELL BOULEVARD",
            "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": "2002 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014045",
            "telephone_number": "573-785-4959",
            "fax_number": "573-785-6405"
        }
    ],
    "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": "2012-03-09",
        "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": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "302717707",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.