NPIMap

Organization Active NPI

Pro Team Health and Wellness, LLC

  • Sports Physician Chiropractor
  • Phoenix, AZ
National Provider Identifier
1508673393
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
PRO TEAM HEALTH AND WELLNESS, LLC
Practice address
4602 N 16TH St Ste 202
Phoenix, AZ 85016-5161
Phone
(602) 714-3690
NPI assigned
Dec 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Dominic Bartola
Title
Partner
Phone
(602) 558-1427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X Primary

Addresses

Primary practice location

4602 N 16TH St Ste 202
Phoenix, AZ 85016-5161

Mailing address

4602 N 16TH St Ste 202
Phoenix, AZ 85016-5161
Phone (602) 714-3690

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1508673393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 N 16TH ST STE 202",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165161",
            "telephone_number": "602-714-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 N 16TH ST STE 202",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165161",
            "telephone_number": "602-714-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO TEAM HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-15",
        "status": "A",
        "authorized_official_last_name": "BARTOLA",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "602-558-1427"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.