Augustine Julie Prodjinotho, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0043310 Issued in OH

Practice address

3207 Stoneridge LN
Powell, OH 43065-3523

Phone

(928) 503-6643

NPI assigned

Mar 25, 2022

Last updated

Oct 6, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nextcare Arizona LLC

  dba NextCare Urgent Care

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1043371826

  Single Specialty

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AZ

  Medicare reassignment
• Nextcare Arizona I JV LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1114798071

  Single Specialty

  NPD

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1770233355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3207 STONERIDGE LN",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430653523",
            "telephone_number": "928-503-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3207 STONERIDGE LN",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430653523",
            "telephone_number": "928-503-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRODJINOTHO",
        "first_name": "AUGUSTINE",
        "middle_name": "JULIE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0043310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Powell Pharmacy Inc
• Powell Vision Center, Inc
• Christa E Prati, MA CCC-SLP
• Premium Transportation LLC
• Pro Supports Plus, LLC
• Professional Integrative Care LLC
• Elizabeth Puckett, M.A., EDS
• Jessica Puhl, O.D.
• R Health Matters LLC
• Duke Michael Rakich, D.D.S.

• Family Nurse Practitioner in Powell, OH
• Providers in Powell, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.