Organization Active NPI

LV Advanced Care, LLC

  • Specialist
  • Beavercreek, OH
National Provider Identifier
1972931707
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35-076413 Issued in OH
Legal business name
LV ADVANCED CARE, LLC
Practice address
2020 Amys Ridge East CT
Beavercreek, OH 45434-7103
Phone
(937) 427-0517
NPI assigned
Oct 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Authorized official

Name
Seshadri Venkatesh
Title
Manager
Phone
(937) 427-0517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 35-076413 OH Primary

Addresses

Primary practice location

2020 Amys Ridge East CT
Beavercreek, OH 45434-7103

Mailing address

2387 Heather Glen CT
Beavercreek, OH 45431-5625

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131108001674 OH Part B Supplier - Clinic/Group Practice 0648405100 Receives reassigned benefits from 5 practitioners
Practice locations: Beavercreek, OH

National Provider Directory

National Provider Directory

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": "1381708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1972931707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2387 HEATHER GLEN CT",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454315625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 AMYS RIDGE EAST CT",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454347103",
            "telephone_number": "937-427-0517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LV ADVANCED CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-14",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "VENKATESH",
        "authorized_official_first_name": "SESHADRI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "937-427-0517"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35-076413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.