Protact Fit Health

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

PROTACT FIT HEALTH

Practice address

5605 Sheridan Rd
Kenosha, WI 53140-4063

Phone

(312) 448-1460

NPI assigned

Jul 13, 2023

Last updated

Jul 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jude Swift

Title

Founder

Phone

(312) 448-1460

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689206400000",
    "number": "1669151957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1003",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531411003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404063",
            "telephone_number": "312-448-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROTACT FIT HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A",
        "authorized_official_last_name": "SWIFT",
        "authorized_official_first_name": "JUDE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "312-448-1460"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.