NPIMap

Organization Active NPI

Prodigy Healthcare Inc.

  • Community/Behavioral Health Agency
  • Fresno, CA
National Provider Identifier
1508311630
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PRODIGY HEALTHCARE INC.
Practice address
2888 S Ivy Ave
Fresno, CA 93706-5513
Phone
(559) 892-9452
NPI assigned
Aug 18, 2016
Last updated
Aug 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Authorized official

Name
Mr. 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 with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2888 S Ivy Ave
Fresno, CA 93706-5513

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

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 2

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": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1508311630",
    "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": "2888 S IVY AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937065513",
            "telephone_number": "559-892-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY HEALTHCARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.