NPIMap

Organization Active NPI

Prodigy Yoga

Doing business as Prodigy Wellness Collective

  • Clinic/Center
  • Texarkana, AR
National Provider Identifier
1861173874
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PRODIGY YOGA
Doing business as
Prodigy Wellness Collective
Practice address
200 E Broad St
Texarkana, AR 71854-5904
Phone
(210) 860-3493
NPI assigned
Jul 31, 2023
Last updated
Jul 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Authorized official

Name
Mrs. Jessica Renee McCarty, R-YFMT, R-IAYTNPI 1528740677
Title
Owner, Yoga Therapist
Phone
(210) 860-3493

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

200 E Broad St
Texarkana, AR 71854-5904

Mailing address

7 Carol LN
Texarkana, TX 75501-9700
Phone (210) 860-3493

Other practice location 1

3423 New Boston Rd
Texarkana, TX 75501-3137
Phone (210) 860-3493

Other names 2

  • Prodigy Wellness Collective Doing business as
  • Prodigy Life Other name

National Provider Directory

National Provider Directory

Locations

200 E Broad St
Texarkana, AR 71854
Phone (210) 860-3493

3423 New Boston Rd
Texarkana, TX 75501
Phone (210) 860-3493

Practitioners & affiliated clinicians

Practitioners 6

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": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1861173874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CAROL LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755019700",
            "telephone_number": "210-860-3493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E BROAD ST",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718545904",
            "telephone_number": "210-860-3493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3423 New Boston Rd",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755013137",
            "country_code": "US",
            "telephone_number": "210-860-3493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRODIGY YOGA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "MCCARTY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER, YOGA THERAPIST",
        "authorized_official_telephone_number": "210-860-3493",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R-YFMT, R-IAYT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prodigy Wellness Collective",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prodigy Life",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Texarkana, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.