Alexis Katelynn Prowker

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

133 N River St
Wilkes Barre, PA 18711-0800

Phone

(570) 208-5925

NPI assigned

Aug 27, 2020

Last updated

Aug 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Practice roles

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

• King's College

  • Student Health Clinic/Center
  • Wilkes Barre, PA
  • NPI 1164749966
  NPD (past)

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

{
    "created_epoch": "1598486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1881207033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 STATE RD",
            "city": "COOPERSBURG",
            "state": "PA",
            "postal_code": "180369626",
            "telephone_number": "267-347-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110800",
            "telephone_number": "570-208-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROWKER",
        "first_name": "ALEXIS",
        "middle_name": "KATELYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-27",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Christopher Price, M.D.
• Rodney E Price, BA
• Priority 1 Emergency Medical Services
• Rene L Pristas, MD
• Bogdan Protyniak, MD, FACS, FASCRS
• Danielle Marie Prudente, PA-C
• Ptest LLC
• David M. Pugliese, D.O.
• Heather Catherine Pugliese, LCSW
• Scarlet D Pujols Recio, CCHW

• Student in an Organized Health Care Education/Training Program in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Student in an Organized Health Care Education/Training Program in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.