Organization Active NPI

Prolific Diagnostics

  • Phlebology Physician
  • Brownsburg, IN
National Provider Identifier
1376300608
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
Legal business name
PROLIFIC DIAGNOSTICS
Practice address
23 Motif Blvd Ste 101
Brownsburg, IN 46112-1065
Phone
(317) 735-6677
NPI assigned
Mar 4, 2024
Last updated
Mar 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Candace Perry, PHLEBOTOMISTNPI 1548028798
Title
Owner
Phone
(317) 735-6677

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
Phlebology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 202K00000X Primary

Addresses

Primary practice location

23 Motif Blvd Ste 101
Brownsburg, IN 46112-1065

Mailing address

23 Motif Blvd Ste 101
Brownsburg, IN 46112-1065
Phone (317) 735-6677

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2323270Prolific Diagnostics23 Motif Blvd Suite 101, Brownsburg, IN 46112Certificate of waiverMay 4, 2027

National Provider Directory

National Provider Directory

Locations

23 Motif Blvd
Ste 101
Brownsburg, IN 46112
Phone (317) 735-6677

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1376300608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MOTIF BLVD STE 101",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461121065",
            "telephone_number": "317-735-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MOTIF BLVD STE 101",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461121065",
            "telephone_number": "317-735-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIFIC DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-735-6677",
        "authorized_official_credential": "PHLEBOTOMIST"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsburg, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.