Prototype Health, Inc

Primary specialty

NaturopathTaxonomy code 175F00000X

Legal business name

PROTOTYPE HEALTH, INC

Practice address

2055 E Southern Ave Ste F
Tempe, AZ 85282-7507

Phone

(480) 999-1717

Fax

(480) 999-0773

NPI assigned

Jul 31, 2021

Last updated

Aug 19, 2022By 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

Dr. Jami Kupperman, NMDNPI 1851510739

Title

Ceo

Phone

(480) 999-1717

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Jami Kupperman, N.D.

  • Naturopath
  • Tempe, AZ
  • NPI 1851510739
  NPD (past) Authorized official
• Jocelyn Constance Bouchard, NMD

  • Naturopath
  • Avondale, AZ
  • NPI 1255003802
  NPD (past)
• David Gallegos, NMD

  • Naturopath
  • Mesa, AZ
  • NPI 1235770587
  NPD (past)

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

{
    "created_epoch": "1627689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1861165144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 E SOUTHERN AVE STE F",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827507",
            "telephone_number": "480-999-1717",
            "fax_number": "480-999-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E SOUTHERN AVE STE F",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827507",
            "telephone_number": "480-999-1717",
            "fax_number": "480-999-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROTOTYPE HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-31",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "KUPPERMAN",
        "authorized_official_first_name": "JAMI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-999-1717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "NMD"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Naturopath in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Naturopath in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.