Proliance MSSP Aco LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PROLIANCE MSSP ACO LLC

Practice address

805 Madison St Ste 901
Seattle, WA 98104-1172

Phone

(206) 264-8100

NPI assigned

Jul 24, 2019

Last updated

Jul 24, 2019By 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

Mr. Mark Barnhart

Title

Ceo

Phone

(206) 838-3796

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1770137127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST STE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 MADISON ST STE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE MSSP ACO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "BARNHART",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-838-3796",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rachel Marie Prokop, RD CD
• Proliance Surgeons Inc P S (Proliance Surgeons Orthopedic Specialists of Seattle)
• Proliance Surgeons Inc P S (Proliance Orthopaedics and Sports Medicine)
• Proliance Surgeons Inc PS (Proliance Center for Specialty Surgery)
• Proliance Surgeons Inc PS (Minor and James Endoscopy Center)
• Proliance Surgeons Inc., P.S. (Northwest Orthopaedic Clinic)

• Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.