ADVANCED MEDICAL HOUSE CALL AND TELEMEDICINE, L.L.C. (NPI# 1083088058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083088058 |
| Entity Type | Organization |
| Organization Name | ADVANCED MEDICAL HOUSE CALL AND TELEMEDICINE, L.L.C. |
| Other Organization Name | ADVANCED MEDICAL EXPRESS CLINIC |
| Practice Address |
624 W Lockling St Brookfield MO 64628-2003 |
| Mailing Address |
Po Box 224 Brookfield MO 64628-0224 |
| Practice Telephone | 6602684006 |
| Practice Fax Number | 6602589006 |
| Mailing Telephone | 6605309992 |
| Mailing Fax Number | 6605309992 |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2018-05-03 |
| Authorized Official Name | MICHAEL PAUL HOLTZ (OWNER/CEO/PROVIDER) |
| Authorized Official Telephone | 6602684006 |
| Authorized Official Credential | FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
2014033136 | MO | Ambulatory Health Care Facilities |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2014033136 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GROUP NPI DBA ADVANCED MEDICAL EXPRESS CLINIC | 1083088058 | 01 | |
| INDIVIDUAL NPI MICHAEL HOLTZ FNP-C | 1518369024 | 01 | |
| GROUP NPI ADVANCED MEDICAL HOUSE CALL AND TELEMEDICINE, LLC | 1083088058 | 01 | |
| INDIVIDUAL NPI COLLAB. PHYS. TERRY THRASHER DO | 1962492223 | 01 |
| Other Name | Type Code |
|---|---|
| Advanced Medical Express Clinic | Doing Business As Name - Organization |
| Street Address |
624 W LOCKLING ST |
| City | BROOKFIELD |
| State | MO |
| Zip Code | 64628-2003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518369024 | Michael Paul Holtz | Nurse Practitioner | 624 W Lockling St, Brookfield, MO 64628-2003 | 2014-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548821747 | Shirley L Arnold | Nurse Practitioner | 624 West Lockling Avenue, Brookfield, MO 64628 | 2019-06-27 |
| 1861761611 | Kristen Marie Butterfield | Physical Therapist | 116 East Pratt, Brookfield, MO 64628 | 2011-12-23 |
| 1588933386 | Jacey Lynne Mohr | Physical Therapy Assistant | 116 E Pratt, Brookfield, MO 64628 | 2011-12-22 |
| 1497841902 | Thomas Ervin Pitts | Dentist | 121 E Brooks St, Brookfield, MO 64628 | 2006-10-04 |
| 1902909559 | Hutchinson Clinic Inc | Allergy & Immunology | 624 W Lockling Ave, Brookfield, MO 64628 | 2006-09-07 |
| 1447257373 | Minerva C Concepcion-rivera | Internal Medicine | 125 East Lockling Avenue, Brookfield, MO 64628 | 2005-07-07 |
| 1992702823 | Pepito C Rivera | Surgery | 130 East Lockling Avenue, Brookfield, MO 64628 | 2005-07-07 |
| 1104322866 | Rebecca Frieda Krc | Emergency Medicine | 130 E Lockling St, Brookfield, MO 64628 | 2018-04-02 |
| 1427251750 | General John J. Pershing Memorial Hospital | Dietitian, Registered | 130 E Lockling St, Brookfield, MO 64628 | 2007-06-06 |
| 1407874126 | General John J Pershing Memorial Hospital Association | Home Health | 130 E Lockling Ave, Brookfield, MO 64628-0408 | 2006-07-18 |
| Find all providers in zip 64628 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871122556 | Mary Kofigah | Nurse Practitioner | 21150 W. Capital Dr., Brookfield, WI 53072 | 2020-04-05 |
| 1295373223 | Joan Marie Bennett | Nurse Practitioner | 125 N Executive Dr Ste 100, Brookfield, WI 53005-6070 | 2019-12-20 |
| 1548821747 | Shirley L Arnold | Nurse Practitioner | 624 West Lockling Avenue, Brookfield, MO 64628 | 2019-06-27 |
| 1306366620 | Tara Hanlon | Nurse Practitioner | 14 Shamrock Drive, Brookfield, CT 06804 | 2017-06-27 |
| 1518369024 | Michael Paul Holtz | Nurse Practitioner | 624 W Lockling St, Brookfield, MO 64628-2003 | 2014-09-16 |
| 1235392218 | Bohdan Kontsevyy | Nurse Practitioner | 3631 Forest Ave Unit P, Brookfield, IL 60513-2262 | 2008-07-09 |
| 1487606794 | Leann Walker | Nurse Practitioner | 1350 Sunny Slope Road, Sunnyslope Primary Care Clinic, Brookfield, WI 53005 | 2006-05-16 |
| 1225644909 | Romy A Desai | Nurse Practitioner | 9139 Broadway Ave, Brookfield, IL 60513-1303 | 2020-09-18 |
| 1457969156 | Stefanie Renee Malesevich | Nurse Practitioner | 16650 W Bluemound Rd Ste 200, Brookfield, WI 53005-5959 | 2020-07-19 |
| 1508482563 | Eula Lewis | Nurse Practitioner | 9139 Broadway Ave, Brookfield, IL 60513-1303 | 2020-06-24 |
| Find all providers in BROOKFIELD | ||||
| City | BROOKFIELD |
| Zip Code | 64628 |
Please comment or provide details below to improve the information on ADVANCED MEDICAL HOUSE CALL AND TELEMEDICINE, L.L.C..
| 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.