Healthcare Provider Details

I. General information

NPI: 1114846219
Provider Name (Legal Business Name): ADVANCED PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 FALL MEADOW LN
BELTON MO
64012-7828
US

IV. Provider business mailing address

PO BOX 126
BELTON MO
64012-0126
US

V. Phone/Fax

Practice location:
  • Phone: 816-288-4895
  • Fax:
Mailing address:
  • Phone: 816-288-4895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: CHERI CAYE VENABLE
Title or Position: MANAGER
Credential: LPN
Phone: 816-288-4895