ADVANCED FAMILY MEDICINE CLINIC INC (NPI# 1184805830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184805830 |
| Entity Type | Organization |
| Organization Name | ADVANCED FAMILY MEDICINE CLINIC INC |
| Practice Address |
327 Medcrest Drive Unit A Crestview FL 32536 |
| Practice Telephone | 8504230761 |
| Practice Fax Number | 8557933568 |
| Mailing Telephone | 8504230761 |
| Mailing Fax Number | 8557933568 |
| Enumeration Date | 2007-11-23 |
| Last Update Date | 2020-04-17 |
| NPI Deactivation Date | 04/10/2020 |
| NPI Reactivation Date | 2020-04-17 |
| Authorized Official Name | KATE R LOPS (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 8504230761 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME89643 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS BLUE SHIELD | 37798 | 01 |
| FL | TRICARE | 1184805830 | 01 |
| FL | AETNA | 1184803830 | 01 |
| FL | HUMANA | 1184805830 | 01 |
| Street Address |
327 MEDCREST DRIVE UNIT A |
| City | CRESTVIEW |
| State | FL |
| Zip Code | 32536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831684901 | Eva Maria I Matute | Adult Companion | 6050 Trestle St, Crestview, FL 32536 | 2018-06-29 |
| 1669989232 | Lauren Estep Flowers | Physician Assistant | 550 Redstone Ave W Ste 370, Crestview, FL 32536 | 2018-01-04 |
| 1427444868 | Jessie Huisken | Social Worker | 5890 Saratoga Dr, Crestview, FL 32536 | 2015-04-13 |
| 1679846166 | John D. Carlson Md | Specialist | 492 North Wilson Street, Crestview, FL 32536 | 2012-02-15 |
| 1154609691 | Alternative Living, Inc. | Assisted Living Facility | 603 North Pearl Street, Crestview, FL 32536 | 2011-08-02 |
| 1487821526 | Michael G Foley Md Pa | Internal Medicine | 524 James Lee Blvd W, Crestview, FL 32536 | 2008-05-08 |
| 1164631511 | Caring Hearts Pediatric Extended Care Center, Inc | Clinic/Center | 380 Medcrest Dr, Crestview, FL 32536 | 2007-05-22 |
| 1669697751 | Crestview Chiropractic Clinic, Inc. | Chiropractor | 1078 S. Ferdon Boulevard, Suite A, Crestview, FL 32536 | 2007-04-16 |
| 1457492886 | Roy M Nakaiye | Dentist | 222 Cedar Ave, Crestview, FL 32536 | 2007-02-09 |
| 1114063187 | Misti D Anderson | Counselor | 502 N. Ferdon Blvd., B, Crestview, FL 32536 | 2007-01-29 |
| Find all providers in zip 32536 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144451550 | Andy Bruce Carter | Family Medicine | 613 Red Fern Rd, Crestview, FL 32536-5472 | 2009-08-03 |
| 1801905039 | Marcene Faye Kreifels | Family Medicine | 1198 S Ferdon Blvd, Crestview, FL 32536-4512 | 2006-08-30 |
| 1518938653 | Kate R Lops | Family Medicine | 327 Medcrest Dr Unit A, Crestview, FL 32536 | 2006-01-27 |
| 1235126582 | Jimmie Dale Bailey II | Family Medicine | 3580 Airport Rd, Crestview, FL 32539-6185 | 2005-10-03 |
| 1447244223 | Ann Kathryn Gwinnup | Family Medicine | 127 E Redstone Ave Ste C, Crestview, FL 32539-5356 | 2005-09-07 |
| 1689802993 | Kerrian A Hudson | Family Medicine | 550 W Redstone Ave, 200, Crestview, FL 32536-6429 | 2009-06-25 |
| 1942441795 | Kara O Brooks | Family Medicine | 550 Redstone Ave W, Suite 200, Crestview, FL 32536-6428 | 2009-03-07 |
| 1467609198 | Paul Nicholas Motta | Family Medicine | 127 E Redstone Ave, Suite C, Crestview, FL 32539-5358 | 2008-08-25 |
| 1477739829 | Michelle H Stevens Md Pa | Family Medicine | 4100 S Ferdon Blvd, Ste C5, Crestview, FL 32536-5252 | 2008-01-16 |
| 1710173638 | James L Willis Do Pa | Family Medicine | 524 W James Lee Blvd, Crestview, FL 32536-5129 | 2007-09-25 |
| Find all providers in CRESTVIEW | ||||
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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.