ADVANCED WELLNESS GROUP INC — NPI 1003099235 (Licensed & Credentialed Medical Genetics, Ph.D. Medical Genetics in QUINLAN, TX)

CMS-1500 Box 24J / 33a • NPI

1003099235

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

170100000X

Licensed & Credentialed Medical Genetics, Ph.D. Medical Genetics

Box 32 Service Location & ZIP+4

2705 E QUINLAN PKWY, QUINLAN, TX, 75474-8688

✓ 9-Digit EDI 837 ZIP+4 (75474-8688)

Practice Phone & Referral Fax

(903) 447-5470

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1003099235 (ADVANCED WELLNESS GROUP INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1003099235` (NPI-2 Organization / Facility)
Provider / Legal Name	ADVANCED WELLNESS GROUP INC
Plain-English Specialty	Licensed & Credentialed Medical Genetics, Ph.D. Medical Genetics NUCC Code: `170100000X` (Medical Genetics, Ph.D. Medical Genetics)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2705 E QUINLAN PKWY, QUINLAN, TX, 75474-8688
Practice Telephone / Fax	Tel: (903) 447-5470
Administrative Mailing Address	PO BOX 789, QUINLAN, TX, 75474-0014
Enumeration & Last Sync	Enumerated: 2007-12-11 \| CMS Record Updated: 2012-10-17
Authorized Official	KENNETH DORITY (SUPERVISING PHYSICIAN)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2705 E QUINLAN PKWY, QUINLAN, TX, 75474-8688

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Plain-English Taxonomy & CMS Crosswalk (170100000X)

What Does Taxonomy Code 170100000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 170100000X translates to:
"Licensed & Credentialed Medical Genetics, Ph.D. Medical Genetics"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Medical Genetics, Ph.D. Medical Genetics for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ADVANCED WELLNESS GROUP INC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`170100000X` — Medical Genetics, Ph.D. Medical Genetics Plain English: Licensed & Credentialed Medical Genetics, Ph.D. Medical Genetics	State: TX \| License: `K0722` \| Primary: Yes (Primary)

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ADVANCED WELLNESS GROUP INC (NPI #1003099235)