ADVANTAGE FAMILY HEALTHCARE PLLC NPI 1184629735

NPI Information

NPI: 1184629735
Provider Name: ADVANTAGE FAMILY HEALTHCARE, PLLC

Doing Business As: CAMPBELL STATION PRIMARY CARE ASSOC

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
11541 KINGSTON PIKE
STE 101
KNOXVILLE, TN
ZIP 37934
Phone: (865) 675-7522
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ADVANTAGE FAMILY HEALTHCARE, PLLC is a family nurse practitioner in Knoxville, TN. ADVANTAGE FAMILY HEALTHCARE, PLLC NPI is 1184629735. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Campbell Station Primary Care Assoc.

The provider's business location address is:

11541 KINGSTON PIKE
STE 101
KNOXVILLE, TN
ZIP 37934-918
Phone: (865) 675-7522
Fax: (865) 671-3196

The provider's authorized official is Robert Michael Martin .
The authorized official title is Chief Manager / Provider and has the following contact phone number (865) 675-7522.

The CLIA number assigned to this NPI record is 44D0993636 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/19/2005 and was last updated on 5/3/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	APN7953	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3908484	MEDICARE ID-TYPE UNSPECIFIED		PERFORMING PROVIDER #
2	1922004159	OTHER		INDIVIDUAL NPI
3	1659403590	OTHER		GROUP NPI
4	P19355	MEDICARE UPIN
5	3908484	MEDICAID	TENNESSEE
6	44D0993636	OTHER		CLIA ID NUMBER
7	3728422	MEDICARE ID-TYPE UNSPECIFIED		GROUP PRICING NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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