Organization Active NPI

Advanced Health Care, LLC

  • Family Medicine Physician
  • Lee's Summit, MO
National Provider Identifier
1356442669
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVANCED HEALTH CARE, LLC
Practice address
1631 NE Douglas St
Lees Summit, MO 64086-4701
Phone
(816) 525-6688
Fax
(816) 554-7227
NPI assigned
Sep 26, 2006
Last updated
Oct 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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

Authorized official

Name
Dr. Raymond VasquezNPI 1851492292
Title
President
Phone
(816) 525-6688

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X MO
Internist Chiropractor 111NI0900X MO
Family Medicine Physician 207Q00000X MO Primary

Addresses

Primary practice location

1631 NE Douglas St
Lees Summit, MO 64086-4701

Mailing address

1631 NE Douglas St
Lees Summit, MO 64086-4701
Phone (816) 525-6688

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070608000355 MO Part B Supplier - Clinic/Group Practice 9234237652 Receives reassigned benefits from 1 practitioner
Practice locations: Lees Summit, MO

National Provider Directory

National Provider Directory

Locations

1631 NE Douglas St
Lees Summit, MO 64086
Phone (816) 381-2050

Practitioners & affiliated clinicians

Practitioners 1

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": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1356442669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 NE DOUGLAS ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640864701",
            "telephone_number": "816-525-6688",
            "fax_number": "816-554-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 NE DOUGLAS ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640864701",
            "telephone_number": "816-525-6688",
            "fax_number": "816-554-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-525-6688",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.