Advent Family Practice, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

BK6520806 Issued in FL

Legal business name

ADVENT FAMILY PRACTICE, INC

Doing business as

Advent Family Practice

Practice address

1447 Medical Park Blvd
405
Wellington, FL 33414-3164

Phone

(561) 792-7484

Fax

(561) 792-7454

NPI assigned

May 10, 2006

Last updated

Oct 25, 2012By 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

Dr. Edward K Kankam, D.O.

Title

President

Phone

(561) 792-7484

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advent Family Practice Doing business as

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1982654299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD.",
            "address_2": "405",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143164",
            "telephone_number": "561-792-7484",
            "fax_number": "561-792-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD",
            "address_2": "405",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143164",
            "telephone_number": "561-792-7484",
            "fax_number": "561-792-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENT FAMILY PRACTICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "KANKAM",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-792-7484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "BK6520806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260022600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advent Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Wellington, FL
• Providers in Wellington, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.