NPIMap

Organization Active NPI

Pro Balance LLC

  • Prosthetic/Orthotic Supplier
  • Kingsport, TN
National Provider Identifier
1104012319
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
PRO16 Issued in TN
Legal business name
PRO BALANCE LLC
Practice address
2408 Fort Henry Drive
Kingsport, TN 37664
Phone
(423) 246-7272
Fax
(423) 246-2803
NPI assigned
Sep 20, 2007
Last updated
Jan 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Authorized official

Name
Mrs. Gilgia Prumbs, PTNPI 1003874249
Title
Member
Phone
(423) 246-7272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X PRO16 TN Primary

Addresses

Primary practice location

2408 Fort Henry Drive
Kingsport, TN 37664

Mailing address

2408 Fort Henry Drive
Kingsport, TN 37664
Phone (423) 246-7272

National Provider Directory

National Provider Directory

Locations

2408 Fort Henry Dr
Kingsport, TN 37664
Phone (423) 246-7272

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1104012319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 FORT HENRY DRIVE",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37664",
            "telephone_number": "423-246-7272",
            "fax_number": "423-246-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 FORT HENRY DRIVE",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37664",
            "telephone_number": "423-246-7272",
            "fax_number": "423-246-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO BALANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "PRUMBS",
        "authorized_official_first_name": "GILGIA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "423-246-7272",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TN",
            "license": "PRO16",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.