Active NPI
Advanced Health & Wellness Center
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- Anthem, AZ
National Provider Identifier
1609205863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- Legal business name
- ADVANCED HEALTH & WELLNESS CENTER
- Practice address
- 42104 N Venture Dr Ste A102
Anthem, AZ 85086-3824 - Phone
- (480) 322-1553
- NPI assigned
- Nov 7, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eric Poole
- Title
- Manager/Member
- Phone
- (480) 315-8322
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | |||
| Sports Medicine (Neuromusculoskeletal Medicine) Physician | 204C00000X | Primary | ||
| Primary Care Nurse Practitioner | 363LP2300X |
Addresses
Primary practice location
42104 N Venture Dr Ste A102
Anthem, AZ 85086-3824
Mailing address
42104 N Venture Dr Ste A102
Anthem, AZ 85086-3824
Phone (480) 322-1553
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383782400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1750723200000",
"number": "1609205863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42104 N VENTURE DR STE A102",
"city": "ANTHEM",
"state": "AZ",
"postal_code": "850863824",
"telephone_number": "480-322-1553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42104 N VENTURE DR STE A102",
"city": "ANTHEM",
"state": "AZ",
"postal_code": "850863824",
"telephone_number": "480-322-1553"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED HEALTH & WELLNESS CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2013-11-07",
"last_updated": "2025-06-24",
"certification_date": "2025-06-24",
"status": "A",
"authorized_official_last_name": "POOLE",
"authorized_official_first_name": "ERIC",
"authorized_official_title_or_position": "MANAGER/MEMBER",
"authorized_official_telephone_number": "480-315-8322"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": false
},
{
"code": "204C00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Neuromusculoskeletal Medicine, Sports Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Anthem, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.