Organization Active NPI

Prohealth Therapeutics

  • Clinical Medical Laboratory
  • Colorado Springs, CO
National Provider Identifier
1689449092
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PROHEALTH THERAPEUTICS
Practice address
4835 Centennial Blvd
Colorado Springs, CO 80919-3308
Phone
(646) 713-6033
NPI assigned
Nov 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Authorized official

Name
Dr. Pradeep Rai, MD
Title
Medical Director
Phone
(646) 713-6033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

4835 Centennial Blvd
Colorado Springs, CO 80919-3308

Mailing address

2925 E Colfax Ave
Denver, CO 80206-1604
Phone (303) 209-5115

National Provider Directory

National Provider Directory

Locations

2925 E Colfax Ave
Denver, CO 80206
Phone (303) 209-5115

NPI Registry JSON

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1689449092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 E COLFAX AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802061604",
            "telephone_number": "303-209-5115",
            "fax_number": "833-603-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 CENTENNIAL BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193308",
            "telephone_number": "646-713-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH THERAPEUTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-16",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "RAI",
        "authorized_official_first_name": "PRADEEP",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "646-713-6033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.