Prolo & Integrated Medicine, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MB03954800 Issued in NJ

Legal business name

PROLO & INTEGRATED MEDICINE, LLC

Practice address

532 Lafayette Rd
Sparta, NJ 07871-4411

Phone

(973) 362-5227

Fax

(973) 250-0045

NPI assigned

Sep 28, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Walter Grote, D.O.NPI 1811983745

Title

Provider

Phone

(973) 362-5227

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Walter R Grote, DO

  • Internal Medicine Physician
  • Sparta, NJ
  • NPI 1811983745
  Authorized official Same address or phone

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348790400000",
    "number": "1134470222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "city": "BLAIRSTOWN",
            "state": "NJ",
            "postal_code": "078250297",
            "telephone_number": "973-362-5227",
            "fax_number": "973-250-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 LAFAYETTE RD",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078714411",
            "telephone_number": "973-362-5227",
            "fax_number": "973-250-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLO & INTEGRATED MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2012-09-28",
        "status": "A",
        "authorized_official_last_name": "GROTE",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "973-362-5227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB03954800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0341401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Sparta, NJ
• Providers in Sparta, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; 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.