NPIMap

Organization Active NPI

Prospect Inc.

  • Physical Therapist
  • Manchester, ME
National Provider Identifier
1790830255
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2546 Issued in ME
Legal business name
PROSPECT INC.
Practice address
6 Rockwood Dr.
Suite #2
Manchester, ME 04351-0552
Phone
(207) 626-3333
Fax
(207) 626-3334
NPI assigned
Jan 24, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. David James Pickle, MSPTNPI 1770752438
Title
Ceo
Phone
(207) 626-3333

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
Physical Therapist 225100000X PT2546 ME Primary

Addresses

Primary practice location

6 Rockwood Dr.
Suite #2
Manchester, ME 04351-0552

Mailing address

6 Rockwood Drive
Suite #2
Manchester, ME 04351-0552
Phone (207) 626-3333

Other identifiers 1

IdentifierTypeStateIssuer
060722OtherMEBLUE CROSS, BLUE SHIELD

Other names 1

  • Prospect Sports Medicine & Rehabilitation Other name

National Provider Directory

National Provider Directory

Locations

6 Rockwood Dr
#2
Manchester, ME 04351
Phone (207) 626-3333

Practitioners & affiliated clinicians

Practitioners 2

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": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790830255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ROCKWOOD DRIVE",
            "address_2": "SUITE #2",
            "city": "MANCHESTER",
            "state": "ME",
            "postal_code": "043510552",
            "telephone_number": "207-626-3333",
            "fax_number": "207-626-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ROCKWOOD DR.",
            "address_2": "SUITE #2",
            "city": "MANCHESTER",
            "state": "ME",
            "postal_code": "043510552",
            "telephone_number": "207-626-3333",
            "fax_number": "207-626-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PICKLE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-626-3333",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS, BLUE SHIELD",
            "identifier": "060722",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prospect Sports Medicine & Rehabilitation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Manchester, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.