Individual provider Active NPI

Prosper Joseph, M.D.

  • Prescribing (Medical) Psychologist
  • Lake Worth, FL
National Provider Identifier
1881001972
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
2343212 Issued in FL
Practice address
1774 15TH Ave N
Lake Worth, FL 33460-1734
Phone
(407) 965-9329
Fax
(786) 272-0476
NPI assigned
Jul 21, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X RPHT3903 FL
Prescribing (Medical) Psychologist 103TP0016X 2343212 FL Primary

Addresses

Primary practice location

1774 15TH Ave N
Lake Worth, FL 33460-1734

Mailing address

1774 15TH Ave N
Lake Worth, FL 33460-1734
Phone (407) 965-9329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2343212FLMDPrescribing (Medical) Psychologist
RPHT3903FLMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Virgo Health Care Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1881001972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 15TH AVE N",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334601734",
            "telephone_number": "407-965-9329",
            "fax_number": "786-272-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1774 15TH AVE N",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334601734",
            "telephone_number": "407-965-9329",
            "fax_number": "786-272-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "PROSPER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-21",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "FL",
            "license": "RPHT3903",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "FL",
            "license": "2343212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.