Advanced Medical Centers LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME42368 Issued in FL

Legal business name

ADVANCED MEDICAL CENTERS LLC

Practice address

6910 Atlantic Blvd
Jacksonville, FL 32211-8704

Phone

(904) 805-0099

NPI assigned

Jul 29, 2008

Last updated

Nov 7, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Fred Carter Wilson, DCNPI 1568404713

Title

Manager

Phone

(904) 805-0099

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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.

• Jesse Quinn Owens Badger, PA-C

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1902027717
  Medicare reassignment
• John D Foster, MD

  • General Practice Physician
  • Atlantic Beach, FL
  • NPI 1801842638
  Medicare reassignment
• Fred Carter Wilson, D.C.

  • Chiropractor
  • Jacksonville, FL
  • NPI 1568404713
  Authorized official Same address or phone

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510012800000",
    "number": "1548426638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322118704",
            "telephone_number": "904-805-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322118704",
            "telephone_number": "904-805-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2017-11-07",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "CARTER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "904-805-0099",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH007302",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME42368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Advanced Otolaryngology Services PA
• Advanced Pain Management Clinic, Inc
• Advanced Pain Management Clinic, LLC

• General Practice Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; 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.