NPIMap

Organization Active NPI

Advance Community Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Fuquay Varina, NC
National Provider Identifier
1982845103
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ADVANCE COMMUNITY HEALTH, INC
Practice address
130 N Judd Pkwy NE
Fuquay Varina, NC 27526-2367
Phone
(919) 833-3111
Fax
(919) 834-3118
NPI assigned
Mar 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Authorized official

Name
Penella M Washington
Title
Ceo
Phone
(919) 250-2923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

130 N Judd Pkwy NE
Fuquay Varina, NC 27526-2367

Mailing address

1001 Rock Quarry Rd
Raleigh, NC 27610-3825
Phone (919) 833-3111

Other identifiers 1

IdentifierTypeStateIssuer
344584CMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Wake Health Services in17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

130 N Judd Pkwy NE
Fuquay Varina, NC 27526
Phone (919) 346-0499

Practitioners & affiliated clinicians

Practitioners 1

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": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587427200000",
    "number": "1982845103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ROCK QUARRY RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276103825",
            "telephone_number": "919-833-3111",
            "fax_number": "919-834-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N JUDD PKWY NE",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262367",
            "telephone_number": "919-833-3111",
            "fax_number": "919-834-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE COMMUNITY HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-18",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "PENELLA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-250-2923"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344584C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.