NPIMap

Organization Active NPI

Advanced Healthcare Services, LLC

  • Home Health Agency
  • Springfield, IL
National Provider Identifier
1346398351
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1010686 Issued in IL
Legal business name
ADVANCED HEALTHCARE SERVICES, LLC
Practice address
3900 Pintail Drive
Suite a
Springfield, IL 62711-7380
Phone
(217) 726-6956
Fax
(217) 726-7082
NPI assigned
Jan 8, 2007
Last updated
Dec 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Authorized official

Name
Cristina Caoili Agno, R.N.
Title
Administrator/Managing Member
Phone
(217) 726-6956

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1010686 IL Primary

Addresses

Primary practice location

3900 Pintail Drive
Suite a
Springfield, IL 62711-7380

Mailing address

3900 Pintail Drive
Suite a
Springfield, IL 62711-7380
Phone (217) 726-6956

Other identifiers 1

IdentifierTypeStateIssuer
204562962001MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070111000249 IL Part A Provider - Home Health Agency 6608876818 Practice locations: Springfield, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346398351. Details of each certification follow.

Home health agency certification: CCN 147945

Legal name
ADVANCED HEALTHCARE SERVICES, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 5, 2007
Last certification
Dec 6, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Mar 13, 2006 in IL
Enrollment address
3900 Pintail Drive
Suite a
Springfield, IL 62711-7380

Care Compare: Home health agency

Medicare Care Compare
Listed as
Advanced Healthcare Services, LLCCCN 147945 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Apr 5, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

3900 Pintail Dr
Ste A
Springfield, IL 62711
Phone (217) 726-6956

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Maria Cristina J Agno Individual 5% Or Greater Direct Ownership Interest Nov 23, 2006 38%
General Partnership Interest Nov 23, 2006 38%
Corporate OfficerCeo / Secretary Jan 1, 2013
Corporate Director Nov 23, 2006
Judy C Agno Individual Corporate OfficerPresident, Managing Member Mar 13, 2006 62%
Operational/Managerial Control Nov 1, 2016 100%

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

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.

Affiliated clinicians 39

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323907200000",
    "number": "1346398351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 PINTAIL DRIVE",
            "address_2": "SUITE A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117380",
            "telephone_number": "217-726-6956",
            "fax_number": "217-726-7082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 PINTAIL DRIVE",
            "address_2": "SUITE A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117380",
            "telephone_number": "217-726-6956",
            "fax_number": "217-726-7082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2011-12-15",
        "status": "A",
        "authorized_official_last_name": "AGNO",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_middle_name": "CAOILI",
        "authorized_official_title_or_position": "ADMINISTRATOR/MANAGING MEMBER",
        "authorized_official_telephone_number": "217-726-6956",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204562962001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.