NPIMap

Organization Active NPI

Advanced Health Center PLLC

  • Integrative Medicine Physician
  • Tyler, TX
National Provider Identifier
1760128995
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Integrative Medicine PhysicianTaxonomy code 202D00000X
Legal business name
ADVANCED HEALTH CENTER PLLC
Practice address
1400 WSW Loop 323 Ste 60
Tyler, TX 75701-7059
Phone
(903) 526-4875
Fax
(903) 526-4876
NPI assigned
May 10, 2022
Last updated
Aug 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Dr. Janet Rene Keais, DO
Title
Medical Director
Phone
(903) 830-9222

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Integrative Medicine Physician 202D00000X Primary

Addresses

Primary practice location

1400 WSW Loop 323 Ste 60
Tyler, TX 75701-7059

Mailing address

1400 WSW Loop 323 Ste 60
Tyler, TX 75701-7059
Phone (903) 526-4875

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220727000030 TX Part B Supplier - Clinic/Group Practice 6305228131 Receives reassigned benefits from 6 practitioners
Practice locations: Tyler, TX

National Provider Directory

National Provider Directory

Locations

1400 W Southwest Loop 323
Ste 60
Tyler, TX 75701
Phone (903) 526-4875

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1760128995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WSW LOOP 323 STE 60",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757017059",
            "telephone_number": "903-526-4875",
            "fax_number": "903-526-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WSW LOOP 323 STE 60",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757017059",
            "telephone_number": "903-526-4875",
            "fax_number": "903-526-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEALTH CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "KEAIS",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "903-830-9222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.