Prototype Health PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PROTOTYPE HEALTH PLLC

Practice address

434 N Trade St # 103
Matthews, NC 28105-1864

Phone

(850) 776-3237

NPI assigned

May 29, 2019

Last updated

May 29, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael L Goetsch, DCNPI 1063921674

Title

Director

Phone

(850) 776-3237

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Leonard Goetsch, DC

  • Chiropractor
  • Matthews, NC
  • NPI 1063921674
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1023675717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 CRAMER CIR APT 303",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297077860",
            "telephone_number": "850-776-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 N TRADE ST # 103",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281051864",
            "telephone_number": "850-776-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROTOTYPE HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "GOETSCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "850-776-3237",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Matthews, NC
• Providers in Matthews, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.