# MEDADVANCE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104634377
- **Authorized official:** TRACY WIMBERG (VP BILLING OPERATIONS)
- **Authorized official phone:** (609) 517-2526

## Contact information

- **Practice address:** 800 S GAY ST STE 700, KNOXVILLE, TN 37929-9703
- **Practice address phone:** (440) 652-8748
- **Practice address fax:** (440) 582-3171
- **Mailing address:** 731 BAY AVE, SOMERS POINT, NJ 08244-2378
- **Mailing address fax:** (440) 582-3171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/20/2024
- **Last updated:** 10/15/2026