Advance Nurse Registry, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

30211761 Issued in FL

Legal business name

ADVANCE NURSE REGISTRY, LLC

Practice address

2817 E Oakland Park Blvd
Suite 200-B2
Fort Lauderdale, FL 33306-1889

Phone

(888) 832-8850

NPI assigned

Feb 18, 2015

Organization subpart

No

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

Authorized official

Name

Raynor Bingham

Title

Chief Financial Officer

Phone

(954) 892-1561

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1972995504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 E OAKLAND PARK BLVD",
            "address_2": "SUITE 200-B2",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061889",
            "telephone_number": "888-832-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 E OAKLAND PARK BLVD",
            "address_2": "SUITE 200-B2",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061889",
            "telephone_number": "888-832-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE NURSE REGISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-18",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "BINGHAM",
        "authorized_official_first_name": "RAYNOR",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "954-892-1561"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "FL",
            "license": "30211761",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "30211761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA",
            "identifier": "30211761",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.