Eric John Prokopovich, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

02005745A Issued in IN

Practice address

598 Geiger Boulevard
Beaufort, SC 29904

Phone

(770) 362-8657

NPI assigned

Mar 28, 2018

Last updated

Mar 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1851896203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER SAN DIEGO 38400 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921345000",
            "telephone_number": "770-362-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 GEIGER BOULEVARD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "29904",
            "telephone_number": "770-362-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKOPOVICH",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "02005745A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primary & Specialty Care for Assisted Living & Independent Living
• Primecare Health Center PA
• PRN Staffers BSC, LLC (PRN Staffers Inc)
• Marsha Probst
• Profiles
• Jenna Marie Prokopovich, RN BSN
• Jacquelyn Faith Proulx, D.M.D.
• Publix Super Markets Inc (Publix Pharmacy #1463)
• Publix Super Markets, Inc. (Publix Pharmacy #1716)
• Kaitlin Putnam

• General Practice Physician in Beaufort, SC
• Providers in Beaufort, SC by specialty
• General Practice Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.