Organization Active NPI

Prosper Functional Health LLC

  • Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1083439921
Registry record updated Nov 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
PROSPER FUNCTIONAL HEALTH LLC
Practice address
856 N Tyndall Pkwy
Panama City, FL 32404-9407
Phone
(850) 270-7360
NPI assigned
Nov 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2024

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

Authorized official

Name
Mr. Aaron Redmond, APRNNPI 1144780024
Title
Manager
Phone
(850) 867-4332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

856 N Tyndall Pkwy
Panama City, FL 32404-9407

Mailing address

856 N Tyndall Pkwy
Panama City, FL 32404-9407
Phone (850) 270-7360

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1731715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731715200000",
    "number": "1083439921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 N TYNDALL PKWY",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324049407",
            "telephone_number": "850-270-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 N TYNDALL PKWY",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324049407",
            "telephone_number": "850-270-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPER FUNCTIONAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-16",
        "last_updated": "2024-11-16",
        "certification_date": "2024-11-16",
        "status": "A",
        "authorized_official_last_name": "REDMOND",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "850-867-4332",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2024; 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.