Profile Plan, LLC

Primary specialty

Obesity Medicine (Preventive Medicine) PhysicianTaxonomy code 2083B0002X

Legal business name

PROFILE PLAN, LLC

Doing business as

Profile

Practice address

4800 W 57TH St
Sioux Falls, SD 57108-2239

Phone

(605) 376-6659

NPI assigned

May 9, 2022

Last updated

May 9, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Corey M Condon

Title

Senior Product Officer

Phone

(605) 376-6659

Specialties & licenses 1

Addresses

Other names 1

• Profile Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1194461541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 W 57TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082239",
            "telephone_number": "605-376-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 W 57TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082239",
            "telephone_number": "605-376-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFILE PLAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-09",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR PRODUCT OFFICER",
        "authorized_official_telephone_number": "605-376-6659"
    },
    "taxonomies": [
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "@profileplan.com",
            "affiliation": "N",
            "endpointDescription": "Business Website",
            "address_1": "4800 W 57th St",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571082239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Profile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Obesity Medicine (Preventive Medicine) Physician in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Obesity Medicine (Preventive Medicine) Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.