Prodigal Primary Care PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRODIGAL PRIMARY CARE PC

Practice address

901 Merchant Dr
Knoxville, TN 37912-3862

Phone

(865) 474-1053

Fax

(865) 951-2401

NPI assigned

Nov 8, 2012

Organization subpart

No

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

Authorized official

Name

Mr. David E Brickhouse, PA

Title

PA

Phone

(865) 288-3754

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383264000000",
    "number": "1740534049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 ESSARY DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379182468",
            "telephone_number": "865-288-3754",
            "fax_number": "865-243-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MERCHANT DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379123862",
            "telephone_number": "865-474-1053",
            "fax_number": "865-951-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGAL PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-08",
        "last_updated": "2013-11-01",
        "status": "A",
        "authorized_official_last_name": "BRICKHOUSE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PA",
        "authorized_official_telephone_number": "865-288-3754",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riann Joan-Garbett Proctor, LCSW
• Sarah Proctor, LMFT
• Prodigal Family Healthcare
• Prodigal Primary Care
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• Prodigy Mobile Lab & Nursing Concierge
• Professional Dental Systems, North
• Professional Drivers Medical Depots
• Professional Imaging Services LLC

• Durable Medical Equipment & Medical Supplies in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.