Individual provider Active NPI

Mary M Prorok

  • Home Health Registered Nurse
  • Duncansville, PA
National Provider Identifier
1659867083
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
RN245597L Issued in PA
Practice address
125 Maple Hollow Rd
Duncansville, PA 16635-7920
Phone
(814) 693-2273
NPI assigned
Jul 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X RN245597L PA Primary

Addresses

Primary practice location

125 Maple Hollow Rd
Duncansville, PA 16635-7920

Mailing address

125 Maple Hollow Rd
Duncansville, PA 16635-7920

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

State licenses

LicenseStateTypeSpecialty
RN245597LPAMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Private Care Resources, Inc Past Accepting new patients
Private Care Resources, Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1659867083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MAPLE HOLLOW RD",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "166357920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MAPLE HOLLOW RD",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "166357920",
            "telephone_number": "814-693-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROROK",
        "first_name": "MARY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-09",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "PA",
            "license": "RN245597L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncansville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; 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.