NPIMap

Organization Active NPI

Advance Care Medical Georgia, Inc.

Doing business as Advance Care Medical Powder Springs GA

  • Urgent Care Clinic/Center
  • Powder Springs, GA
National Provider Identifier
1619620416
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ADVANCE CARE MEDICAL GEORGIA, INC.
Doing business as
Advance Care Medical Powder Springs GA
Practice address
1064 Richard D Sailors Pkwy
Powder Springs, GA 30127-5221
Phone
(866) 668-2188
NPI assigned
Feb 1, 2022
Last updated
Feb 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Authorized official

Name
Justin Smith
Title
Executive Chairman
Phone
(516) 801-1552

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

1064 Richard D Sailors Pkwy
Powder Springs, GA 30127-5221

Mailing address

3 School St Ste 303
Glen Cove, NY 11542-2548
Phone (866) 668-2188

Other names 1

  • Advance Care Medical Powder Springs GA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Advance Care Medical Georgia Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1064 Richard D Sailors Pkwy
Powder Springs, GA 30127
Phone (678) 486-7777

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1619620416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SCHOOL ST STE 303",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422548",
            "telephone_number": "866-668-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 RICHARD D SAILORS PKWY",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301275221",
            "telephone_number": "866-668-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE CARE MEDICAL GEORGIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "EXECUTIVE CHAIRMAN",
        "authorized_official_telephone_number": "516-801-1552"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advance Care Medical Powder Springs GA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Powder Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.