Advanced Practice Primary Care Staff Associates

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ADVANCED PRACTICE PRIMARY CARE STAFF ASSOCIATES

Practice address

27160 Deerfield LN
Edwardsburg, MI 49112-9663

Phone

(574) 485-9541

NPI assigned

Dec 2, 2021

Organization subpart

No

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

Authorized official

Name

Elizabeth A Van Overberghe, MSN,APRN,FNP-CNPI 1558954495

Title

Family Nurse Practitioner

Phone

(574) 485-9541

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, IN2 enrollments

Enrollment records 2

Practitioners 1

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

• Elizabeth Anne Van Overberghe, FNP

  • Family Nurse Practitioner
  • Granger, IN
  • NPI 1558954495

  MI

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645142400000",
    "number": "1558029983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27160 DEERFIELD LN",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491129663",
            "telephone_number": "574-485-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27160 DEERFIELD LN",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491129663",
            "telephone_number": "574-485-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PRACTICE PRIMARY CARE STAFF ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-02",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A",
        "authorized_official_last_name": "VAN OVERBERGHE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "574-485-9541",
        "authorized_official_credential": "MSN,APRN,FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• All About You Homecare
• Shanna Anthony
• Catherine Ann Bazata, OTR
• Beacon Health Ventures Michigan, Inc.
• Beacon Medical Group, Inc.

• Primary Care Clinic/Center in Edwardsburg, MI
• Providers in Edwardsburg, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.