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ADVANCE CARE LLC NPI 1114427507


NPI Information

NPI: 1114427507
Provider Name: ADVANCE CARE, LLC

Doing Business As: CAREONE MEDICAL CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
14 NORTHTOWN DR STE 105
JACKSON, MS
ZIP 39211
Phone: (601) 397-4079
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ADVANCE CARE, LLC is a family medicine in Jackson, MS. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ADVANCE CARE, LLC NPI is 1114427507. The provider is registered as an organization entity type.
The provider Is Doing Business As Careone Medical Clinic.

The provider's business location address is:

14 NORTHTOWN DR STE 105
JACKSON, MS
ZIP 39211-018
Phone: (601) 397-4079

The provider's authorized official is Tye Rollins .
The authorized official title is Cfo, Clinical Director and has the following contact phone number (601) 397-4079.

The enumeration date for this NPI number is 2/13/2018 and was last updated on 6/16/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QP2300XClinic/CenterPrimary CareNo
2261QU0200XClinic/CenterUrgent CareNo
3207Q00000XFamily MedicineYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100855040MEDICAIDMISSISSIPPI

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: 4/28/2024

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