NPIMap

Organization Active NPI

Prohealth Medical Group Inc

Doing business as ProHealth Care Medical Associates

  • Internal Medicine Physician
  • Menomonee Falls, WI
National Provider Identifier
1912290909
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PROHEALTH MEDICAL GROUP INC
Doing business as
ProHealth Care Medical Associates
Practice address
W165N5595 Creekwood Xing
Menomonee Falls, WI 53051-0685
Phone
(262) 373-2600
NPI assigned
May 24, 2011
Last updated
May 24, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PROHEALTH MEDICAL GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Authorized official

Name
Jim Lyons
Title
President
Phone
(262) 928-7636

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Pulmonary Disease Physician 207RP1001X NU
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU
Plastic Surgery Physician 208200000X NU
Diagnostic Radiology Physician 2085R0202X NU

Addresses

Primary practice location

W165N5595 Creekwood Xing
Menomonee Falls, WI 53051-0685

Mailing address

N17W24100 Riverwood Dr
Suite 250
Waukesha, WI 53188-1177
Phone (262) 928-6225

Other identifiers 1

IdentifierTypeStateIssuer
32652600MedicaidWI

Other names 1

  • ProHealth Care Medical Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Prohealth Medical Group Inc13 organizations share this tax ID, including this one
Part of
Prohealth Medical Group Inc

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1912290909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N17W24100 RIVERWOOD DR",
            "address_2": "SUITE 250",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881177",
            "telephone_number": "262-928-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W165N5595 CREEKWOOD XING",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530510685",
            "telephone_number": "262-373-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROHEALTH MEDICAL GROUP INC",
        "enumeration_date": "2011-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-928-7636"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32652600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProHealth Care Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProHealth Care Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Menomonee Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.