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PROHEALTH MEDICAL GROUP INC
NPI 1417627514
Clinic/Center - Multi-Specialty in Waterford, WI

Active since September 20, 2021
808 CORNERSTONE CT, WATERFORD, WI 53185(262) 928-1977 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: May 23, 2022, Dec 3, 2021, Sep 20, 2021 (3 updates tracked since 2021).

About Prohealth Medical Group Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROHEALTH MEDICAL GROUP INC (NPI 1417627514) is a healthcare organization registered as a multi-specialty in Waterford, Wisconsin and active in the NPI registry since September 2021. The organization lists Thomas W Johnson, Reimbursement Manager, as its authorized official.

NPPES Registry Identity

NPI1417627514
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePROHEALTH MEDICAL GROUP INC
Location Address808 CORNERSTONE CTWaterford, WI 53185-4562
Mailing AddressN17w24100 Riverwood DrWaukesha, WI 53188-1127
Phone(262) 928-1977
Organization SubpartYes
Authorized OfficialThomas W JohnsonReimbursement Manager · (262) 928-4704
Enumeration DateSeptember 20, 2021
Last NPPES UpdateJanuary 22, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 22, 2025
✔ NPI 1417627514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedGeneral PracticeTaxonomy 208D00000X
808 CORNERSTONE CT, Waterford, WI 53185
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRENNA SMITH DPT
Physical Therapist
808 CORNERSTONE CT
WATERFORD, WI 53185
Racine County (262) 928-9725
BAYLEE M SEAMARS OT
Occupational Therapist
808 CORNERSTONE CT
WATERFORD, WI 53185
Racine County (262) 928-9726
RACHEL ADDIS PA-C
Physician Assistant
808 CORNERSTONE CT
WATERFORD, WI 53185
Racine County (262) 928-1977

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prohealth Medical Group Inc's NPI number?

The NPI number for Prohealth Medical Group Inc is 1417627514. It was assigned to this organization in the NPPES registry on September 20, 2021.

Where is Prohealth Medical Group Inc located?

Prohealth Medical Group Inc is located at 808 Cornerstone Ct, Waterford, WI 53185. The listed phone number is (262) 928-1977.

What is Prohealth Medical Group Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Prohealth Medical Group Inc was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.