NPIMap

Organization Active NPI

Prohealth Rural Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Franklin, TN
National Provider Identifier
1104827534
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PROHEALTH RURAL HEALTH SERVICES, INC
Practice address
1325 W Main St
Franklin, TN 37064-3786
Phone
(615) 866-6163
Fax
(615) 794-0018
NPI assigned
Aug 9, 2005
Last updated
Mar 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Authorized official

Name
Dr. Ray White, PHD
Title
President
Phone
(615) 866-6163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1325 W Main St
Franklin, TN 37064-3786

Mailing address

PO Box 682589
Franklin, TN 37068-2589
Phone (615) 591-4750

Other identifiers 2

IdentifierTypeStateIssuer
044-1891MedicaidTN
1505570MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104827534. Details of each certification follow.

  • CCN 441891 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 441891

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
PRO HEALTH-FRANKLIN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 18, 2004
Last certification
Nov 18, 2004
Ownership / control type
For profit – partnership
Facility address
1325 West Main Street, First Floor
Franklin, TN 37064

National Provider Directory

National Provider Directory

Locations

1116 Nashville Hwy
Ste 110
Columbia, TN 38401
Phone (931) 387-7567

1325 W Main St
Ste A
Franklin, TN 37064
Phone (615) 591-4750

388 Harding Pl
Ste B
Nashville, TN 37211
Phone (615) 591-4750

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1104827534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 682589",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370682589",
            "telephone_number": "615-591-4750",
            "fax_number": "615-465-6518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 W MAIN ST",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370643786",
            "telephone_number": "615-866-6163",
            "fax_number": "615-794-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH RURAL HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-866-6163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044-1891",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1505570",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

Verify at the official NPI Registry.