ADVANCE DIAGNOSTIC, LLC (NPI# 1497239024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497239024 |
| Entity Type | Organization |
| Organization Name | ADVANCE DIAGNOSTIC, LLC |
| Practice Address |
1766 Metromedical Dr Fayetteville NC 28304-3861 |
| Practice Telephone | 9109644995 |
| Practice Fax Number | 9193673399 |
| Mailing Telephone | 9109644995 |
| Mailing Fax Number | 9193673399 |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2019-02-04 |
| Authorized Official Name | BARBARA SULLIVAN (OFFICE MANAGER) |
| Authorized Official Telephone | 9109644995 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
Ambulatory Health Care Facilities | ||
| Y | 2085D0003X |
Radiology Specialization: Diagnostic Neuroimaging |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| premier health center | Other Name - Individual/Organization |
| Street Address |
1766 METROMEDICAL DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-3861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265454185 | Rangasamy Ramachandran | Psychiatry & Neurology | 1766 Metromedical Dr, Fayetteville, NC 28304-3861 | 2006-07-24 |
| 1043319197 | Fayetteville Neurology Associates Pa | Psychiatry & Neurology | 1766 Metromedical Dr, Fayetteville, NC 28304-3861 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 2085D0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Neuroimaging |
| A licensed physician, who has completed a residency program in Neurology, and who has additional training, experience, and competence in the standards of performance and interpretation of Magnetic Resonance Imaging (MRI / MRA) of the head, spine, and peripheral nerves, and Computed Tomography (CT) of the head and spine. Physicians are trained in the administration of contrast media and the recognition and treatment of adverse reactions to contrast media. Neuroimaging training encompasses thorough knowledge of clinical neurology, neurophysiology, neuroanatomy, neurochemistry, neuropharmacology, and dynamics of cerebrospinal fluid circulation. Physicians possess special expertise in the technical aspects and clinical applications of each of the modalities and techniques of neuroimaging. |
| Notes: Source: American Academy of Neurology, www.aan.com [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932360187 | Jared B Bowns | Radiology | 3949 Browning Pl, Raleigh, NC 27609-6536 | 2008-06-20 |
| City | FAYETTEVILLE |
| Zip Code | 28304 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.