Healthcare Provider Details

I. General information

NPI: 1649140856
Provider Name (Legal Business Name): ADVANCED HEALING GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8801 BALLENTINE ST STE 400
OVERLAND PARK KS
66214-2082
US

IV. Provider business mailing address

8801 BALLENTINE ST STE 400
OVERLAND PARK KS
66214-2082
US

V. Phone/Fax

Practice location:
  • Phone: 833-381-6736
  • Fax: 833-381-6628
Mailing address:
  • Phone: 833-381-6736
  • Fax: 833-381-6628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: AMY A CHAVEZ
Title or Position: VICE PRESIDENT
Credential:
Phone: 833-381-6736