NPIMap

Organization Active NPI

Prodigy Healthcare, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Caruthers, CA
National Provider Identifier
1144617176
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PRODIGY HEALTHCARE, INC.
Practice address
2580 W Tahoe Ave
Caruthers, CA 93609-9475
Phone
(559) 892-9452
NPI assigned
Apr 16, 2015
Last updated
Apr 16, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
PRODIGY HEALTHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Authorized official

Name
Jagdip DhandaNPI 1194960005
Title
Ceo
Phone
(559) 892-9452

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
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

2580 W Tahoe Ave
Caruthers, CA 93609-9475

Mailing address

PO Box 820
Fowler, CA 93625-0820
Phone (559) 892-9452

National Provider Directory

National Provider Directory
Tax ID family
Prodigy Healthcare Inc18 organizations share this tax ID, including this one
Part of
Prodigy Healthcare Inc

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

2580 W Tahoe Ave
Caruthers, CA 93609
Phone (559) 495-6416

Practitioners & affiliated clinicians

Practitioners 10

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": "1429142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1144617176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820",
            "city": "FOWLER",
            "state": "CA",
            "postal_code": "936250820",
            "telephone_number": "559-892-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 W TAHOE AVE",
            "city": "CARUTHERS",
            "state": "CA",
            "postal_code": "936099475",
            "telephone_number": "559-892-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRODIGY HEALTHCARE, INC.",
        "enumeration_date": "2015-04-16",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "DHANDA",
        "authorized_official_first_name": "JAGDIP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-892-9452"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caruthers, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.