NPIMap

Organization Active NPI

Advanced Family Medicine LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Grove City, OH
National Provider Identifier
1346984242
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
ADVANCED FAMILY MEDICINE LLC
Practice address
4160 Broadway
Grove City, OH 43123-3024
Phone
(614) 875-0079
NPI assigned
Apr 26, 2022
Organization subpart
Yes
Parent organization
ADVANCED FAMILY MEDICINE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Authorized official

Name
Dr. James Cameron Johnson, DONPI 1972535094
Title
Owner
Phone
(614) 875-0079

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 8

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Addiction Medicine (Family Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207QA0401X
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

4160 Broadway
Grove City, OH 43123-3024

Mailing address

4160 Broadway
Grove City, OH 43123-3024
Phone (614) 875-0079

Other identifiers 1

IdentifierTypeStateIssuer
01-8755OtherOHOHIO DEPARTMENT MENTAL HEALTH AND SUBSTANCE ABUSE CERTIFICATION

Other names 1

  • Advanced Family Medicine Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL RXNT.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Advanced Family Medicine LLC3 organizations share this tax ID, including this one
Part of
Advanced Family Medicine LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650931200000",
    "number": "1346984242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 BROADWAY",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431233024",
            "telephone_number": "614-875-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 BROADWAY",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431233024",
            "telephone_number": "614-875-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FAMILY MEDICINE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED FAMILY MEDICINE, LLC",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CAMERON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-875-0079",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO DEPARTMENT MENTAL HEALTH AND SUBSTANCE ABUSE CERTIFICATION",
            "identifier": "01-8755",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "RXNT.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMR",
            "address_1": "4160 Broadway",
            "city": "Grove City",
            "state": "OH",
            "country_code": "US",
            "postal_code": "431233024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Advanced Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grove City, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.