Prodigy Healthcare, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PRODIGY HEALTHCARE, LLC

Practice address

460 N Mesa Dr Ste 101
Mesa, AZ 85201-5949

Phone

(480) 237-7210

NPI assigned

Oct 17, 2019

Last updated

Oct 17, 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

Michael Starkle

Title

Manager

Phone

(480) 999-0259

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571270400000",
    "number": "1083257422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 N MESA DR STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852015949",
            "telephone_number": "480-237-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N MESA DR STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852015949",
            "telephone_number": "480-237-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A",
        "authorized_official_last_name": "STARKLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-999-0259"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Proctor, DPT
• Linda M Proctor
• Linda Susan Proctor
• Prodigee Hospitalists P.C.
• Prodigee Inpatient Physicians Group, P.L.L.C.
• Produce Pharmacy LLC (Esatto Red Mountain)
• Professional Counseling Associates, LLC
• Professional Medical Transport, Inc
• Professional Surgical Assistants of Arizona, LLC (Professional Surgical Services)
• Progressive Homecare Services LLC

• Community/Behavioral Health Agency in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.