Prism Health & Fitness

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

PRISM HEALTH & FITNESS

Practice address

6460 Main St
Williamsville, NY 14221-5838

Phone

(716) 204-1477

Fax

(716) 204-1474

NPI assigned

Mar 16, 2010

Organization subpart

No

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

Authorized official

Name

Mr. David Willard, BS

Title

Site Director

Phone

(716) 204-1477

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1679897953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6460 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215838",
            "telephone_number": "716-204-1477",
            "fax_number": "716-204-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6460 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215838",
            "telephone_number": "716-204-1477",
            "fax_number": "716-204-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM HEALTH & FITNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-16",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "WILLARD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "SITE DIRECTOR",
        "authorized_official_telephone_number": "716-204-1477",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health Educator",
            "state": null,
            "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 Mar 16, 2010; 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.