Advance Healthcare & Wellness Clinic LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

ADVANCE HEALTHCARE & WELLNESS CLINIC LLC

Practice address

1331 Union Ave Ste 1148B
Memphis, TN 38104-7509

Phone

(901) 216-7457

NPI assigned

Mar 9, 2023

Last updated

Mar 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Latonia Williams, NURSE PRACTITIONERNPI 1588137541

Title

FNP-C /Owner Medical Clinic

Phone

(901) 216-7457

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

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.

• Latonia Williams, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Olive Branch, MS
  • NPI 1588137541

  TN

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1851091680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8093 FALCON DR",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386545619",
            "telephone_number": "901-216-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 UNION AVE STE 1148B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381047509",
            "telephone_number": "901-216-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE HEALTHCARE & WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LATONIA",
        "authorized_official_title_or_position": "FNP-C /OWNER MEDICAL CLINIC",
        "authorized_official_telephone_number": "901-216-7457",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.