Organization
ADVANCED FAMILY MEDICINE LLC
Active
Parent organization
ADVANCED FAMILY MEDICINE, LLC
Other names
Advanced Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVANCED FAMILY MEDICINE, LLC
Authorized official
DR. JAMES CAMERON JOHNSON DO (OWNER)
(614) 875-0079
Entity
Organization
Contact information
Practice address
4160 BROADWAY, GROVE CITY, OH 43123-3024
(614) 875-0079
Mailing address
4160 BROADWAY, GROVE CITY, OH 43123-3024
(614) 875-0079
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-8755
OHIO DEPARTMENT MENTAL HEALTH AND SUBSTANCE ABUSE CERTIFICATION
OH
Enumeration date
04/26/2022
Last updated
04/26/2022
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