Prominent Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROMINENT HEALTHCARE LLC

Practice address

5215 N Ironwood Rd Ste 202-I1
Glendale, WI 53217-4915

Phone

(414) 966-3400

Fax

(414) 966-3401

NPI assigned

Feb 4, 2022

Organization subpart

No

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

Authorized official

Name

Ava Michelle Stokes

Title

Owner

Phone

(414) 966-3400

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1780338293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 N IRONWOOD RD STE 202-I1",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174915",
            "telephone_number": "414-966-3400",
            "fax_number": "414-966-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N IRONWOOD RD STE 202-I1",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174915",
            "telephone_number": "414-966-3400",
            "fax_number": "414-966-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMINENT HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "AVA MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-966-3400"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.ProminentHealthCare.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "5215 N Ironwood Rd Ste 202-I1",
            "city": "Glendale",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532174915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathryn Price, RN
• Marisa Ann Prielipp, OTR/L
• Sarah Elizabeth Prioleau, BSN, RN, DNP, CRNA
• Professional Personal Care Servcies
• Prominent Health Care Inc
• Prominent Home Care
• Providence Family Medical Clinic S.C
• Providence Family Pharmacy LLC
• Providence Pharmacy & Wellness
• Renata B Ptak, PA-C

• Home Health Agency in Glendale, WI
• Providers in Glendale, WI by specialty
• Home Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.