Prohealth

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

PROHEALTH

Practice address

808 N 8TH Ave
Pocatello, ID 83201-5718

Phone

(208) 241-1598

NPI assigned

Mar 3, 2021

Organization subpart

No

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

Authorized official

Name

Jacquelyn WheatleyNPI 1669067419

Title

Owner

Phone

(208) 241-1598

Specialties & licenses 4

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacquelyn Wheatley

  • Personal Care Attendant
  • Pocatello, ID
  • NPI 1669067419
  NPD Authorized official

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1285229039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 CEDAR HILLS DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832044400",
            "telephone_number": "208-241-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 N 8TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015718",
            "telephone_number": "208-241-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "WHEATLEY",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-241-1598"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ProHealth@ProHealthhomecareservices.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "808 N 8th Ave",
            "city": "Pocatello",
            "state": "ID",
            "country_code": "US",
            "postal_code": "832015718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Adult Care Home Facility in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Adult Care Home Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.