NPIMap

Organization Active NPI

Advance Nursing Practice Medical Group Inc

  • Family Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1699288993
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ADVANCE NURSING PRACTICE MEDICAL GROUP INC
Practice address
1409 Lecourbe CT
Modesto, CA 95356-8905
Phone
(209) 872-4323
Fax
(209) 409-8239
NPI assigned
Nov 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Authorized official

Name
Mrs. Joselyn Arandia Deculing, RN, NP, FNP-CNPI 1992135081
Title
President
Phone
(209) 872-4323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1409 Lecourbe CT
Modesto, CA 95356-8905

Mailing address

1409 Lecourbe CT
Modesto, CA 95356-8905
Phone (209) 872-4323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200213001217 CA Part B Supplier - Clinic/Group Practice 5597191494 Receives reassigned benefits from 4 practitioners
Practice locations: Modesto, CA

National Provider Directory

National Provider Directory
Tax ID family
Advance Nursing Practice Medical Group Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1649 Countryside Dr
Turlock, CA 95380
Phone (209) 483-8303

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510099200000",
    "number": "1699288993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 LECOURBE CT",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568905",
            "telephone_number": "209-872-4323",
            "fax_number": "209-409-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 LECOURBE CT",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568905",
            "telephone_number": "209-872-4323",
            "fax_number": "209-409-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE NURSING PRACTICE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-08",
        "last_updated": "2017-11-08",
        "status": "A",
        "authorized_official_last_name": "DECULING",
        "authorized_official_first_name": "JOSELYN",
        "authorized_official_middle_name": "ARANDIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-872-4323",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, NP, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.