NPIMap

Organization Active NPI

Prodigious Health Services, LLC

  • Counselor
  • Roxboro, NC
National Provider Identifier
1720389182
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
875 Issued in NC
Legal business name
PRODIGIOUS HEALTH SERVICES, LLC
Practice address
210 N Main St
Roxboro, NC 27573-5325
Phone
(252) 433-0300
Fax
(252) 433-8054
NPI assigned
Nov 16, 2010
Last updated
Nov 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Authorized official

Name
Mr. Bobby Faison, MSNPI 1235285032
Title
President
Phone
(252) 433-0300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 875 NC Primary

Addresses

Primary practice location

210 N Main St
Roxboro, NC 27573-5325

Mailing address

PO Box 2120
Henderson, NC 27536-2120
Phone (252) 433-0300

National Provider Directory

National Provider Directory
Tax ID family
Prodigious Health Services LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

210 N Main St
Roxboro, NC 27573
Phone (336) 330-8000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1720389182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2120",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362120",
            "telephone_number": "252-433-0300",
            "fax_number": "252-433-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N MAIN ST",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275735325",
            "telephone_number": "252-433-0300",
            "fax_number": "252-433-8054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGIOUS HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "FAISON",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-433-0300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxboro, NC

Sources for this page

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