Prohealth Family Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PROHEALTH FAMILY MEDICINE LLC

Doing business as

Prohealth Family Medicine LLC

Practice address

1555 Middleton St
Orangeburg, SC 29115-4791

Phone

(803) 308-7746

NPI assigned

Feb 25, 2020

Organization subpart

No

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

Authorized official

Name

Jobert Aragon Vego

Title

Credentialing

Phone

(803) 614-4131

Specialties & licenses 1

Addresses

Other names 1

• PROHEALTH FAMILY MEDICINE LLC Doing business as

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582588800000",
    "number": "1558995928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291160631",
            "telephone_number": "803-308-7746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 MIDDLETON ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291154791",
            "telephone_number": "803-308-7746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A",
        "authorized_official_last_name": "VEGO",
        "authorized_official_first_name": "JOBERT",
        "authorized_official_middle_name": "ARAGON",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "803-614-4131"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROHEALTH FAMILY MEDICINE LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.