NPIMap

Organization Active NPI

Advance Medical Services, Inc

Doing business as Petersen Medical

  • Oxygen Equipment & Supplies (DME)
  • St George, UT
National Provider Identifier
1487741898
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
6109058-1714 Issued in UT
Legal business name
ADVANCE MEDICAL SERVICES, INC
Doing business as
Petersen Medical
Practice address
2019 E Riverside Dr Ste A100
St George, UT 84790-8147
Phone
(435) 628-4949
Fax
(435) 628-6041
NPI assigned
Oct 6, 2006
Last updated
Nov 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Authorized official

Name
Gordon Ridley
Title
President Ceo
Phone
(801) 373-1010

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X
Oxygen Equipment & Supplies (DME) 332BX2000X 6109058-1714 UT Primary

Addresses

Primary practice location

2019 E Riverside Dr Ste A100
St George, UT 84790-8147

Mailing address

1268 S 1380 W
Orem, UT 84058-4911

Other names 1

  • Petersen Medical Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574640000000",
    "number": "1487741898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 S 1380 W",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840584911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 E RIVERSIDE DR STE A100",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847908147",
            "telephone_number": "435-628-4949",
            "fax_number": "435-628-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE MEDICAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2019-11-25",
        "status": "A",
        "authorized_official_last_name": "RIDLEY",
        "authorized_official_first_name": "GORDON",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "801-373-1010"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "UT",
            "license": "6109058-1714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Petersen Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Petersen Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.