Prizm Healthcare Services PA

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PRIZM HEALTHCARE SERVICES PA

Practice address

229 Golden Oaks LN
St Augustine, FL 32080-6111

Phone

(661) 476-7051

Fax

(904) 471-8569

NPI assigned

Aug 15, 2019

Organization subpart

No

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

Authorized official

Name

William Regan, PHYSICAL THERAPIST

Title

President and Director

Phone

(904) 806-6403

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597881600000",
    "number": "1558917484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 GOLDEN OAKS LN",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320806111",
            "telephone_number": "904-806-6403",
            "fax_number": "904-471-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 GOLDEN OAKS LN",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320806111",
            "telephone_number": "661-476-7051",
            "fax_number": "904-471-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIZM HEALTHCARE SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-15",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A",
        "authorized_official_last_name": "REGAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT AND DIRECTOR",
        "authorized_official_telephone_number": "904-806-6403",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Price
• Ralph David Priddy, PA-C
• Primecare PL
• Bernice Prince Jr., RNFA
• John Edward Prioleau, MD
• Pro Massage
• Sheila Proctor
• Danielle C Prodromides, LMT
• Professional Dental Alliance of St. Augustine, PLLC
• Jessica Diane Proveaux

• Physical Therapy Clinic/Center in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.