Individual provider Active NPI

Alexandra Anthony Prosk, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Austin, TX
National Provider Identifier
1417509316
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP142020 Issued in TX
Practice address
510 Hearn St Ste 100
Austin, TX 78703-4516
Phone
(512) 521-0868
NPI assigned
Jul 10, 2019
Last updated
Sep 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP142020 TX Primary

Addresses

Primary practice location

510 Hearn St Ste 100
Austin, TX 78703-4516

Mailing address

510 Hearn St Ste 100
Austin, TX 78703-4516
Phone (210) 861-1034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
AP142020TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ruby Shoes Psychiatry PLLC CurrentSince Sep 29, 2019 Accepting new patients
Samantha Symons MD PLLC CurrentSince Dec 22, 2019 Accepting new patients

Locations

510 Hearn St
Ste 100
Austin, TX 78703
Phone (512) 521-0868

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1417509316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HEARN ST STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787034516",
            "telephone_number": "210-861-1034",
            "fax_number": "512-521-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 HEARN ST STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787034516",
            "telephone_number": "512-521-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSK",
        "first_name": "ALEXANDRA",
        "middle_name": "ANTHONY",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP142020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.