MEDICARE: ORANGE ADVANCED MEDICAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	111NX0100X	Occupational Health Chiropractor
2	111NP0017X	Pediatric Chiropractor
3	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1912521121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORANGE ADVANCED MEDICAL LLC

Provider Business Mailing Address
First Line	:	5362 E KELTON LN
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254-1144
Country	:	US
Telephone Number	:	623-581-0051
Fax Number	:	581-623-1924

Provider Business Practice Location Address
First Line	:	5362 E KELTON LN
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254-1144
Country	:	US
Telephone Number	:	623-581-0051
Fax Number	:	581-623-1924

Authorized Official
Title or Position	:	MANAGER
Name	:	DONALD D PATTISON
Credential	:	DC
Telephone Number	:	623-581-0051

Provider Enumeration Date	:	06/03/2020
Last Update Date	:	12/09/2025

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Directions to “ORANGE ADVANCED MEDICAL LLC ” Practice Location

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