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PROTOTYPE HEALTH, INC
NPI 1861165144
Naturopath in Tempe, AZ

Active since July 31, 2021CLIA 03D2123430 · Waiver
2055 E SOUTHERN AVE STE F, TEMPE, AZ 85282(480) 999-1717(480) 999-0773 Get Directions Write a Review

NPPES record last updated: August 19, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 19, 2022, Jul 31, 2021 (2 updates tracked since 2021).

About Prototype Health, Inc NPPES

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

PROTOTYPE HEALTH, INC (NPI 1861165144) is a healthcare organization registered as a naturopath in Tempe, Arizona and active in the NPI registry since July 2021. The organization holds a CLIA Waiver certificate valid through December 19, 2026 and lists Jami Kupperman, Ceo, as its authorized official.

NPPES Registry Identity

NPI1861165144
Entity TypeOrganization
Primary Taxonomy175F00000X
Legal Business NamePROTOTYPE HEALTH, INC
Location Address2055 E SOUTHERN AVE STE FTempe, AZ 85282-7507
Mailing Address2055 E Southern Ave Ste FTempe, AZ 85282-7507 · (480) 999-1717 · Fax (480) 999-0773
Phone(480) 999-1717
Fax(480) 999-0773
Organization SubpartNo
Authorized OfficialJami KuppermanCeo · (480) 999-1717
Enumeration DateJuly 31, 2021
Last NPPES UpdateAugust 19, 20222 updates tracked since enumeration
NPPES CertifiedAugust 19, 2022
✔ NPI 1861165144 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNaturopathOther Service Providers
Taxonomy Code175F00000X
Definition
Diagnoses, treats, and cares for patients, using system of practice that bases treatment of physiological functions and abnormal conditions on natural laws governing human body: Utilizes physiological, psychological, and mechanical methods, such as air, water, light, heat, earth, phototherapy, food and herb therapy, psychotherapy, electrotherapy, physiotherapy, minor and orificial surgery, mechanotherapy, naturopathic corrections and manipulation, and natural methods or modalities, together with natural medicines, natural processed foods, and herbs and nature's remedies. Excludes major surgery, therapeutic use of x ray and radium, and use of drugs, except those assimilable substances containing elements or compounds which are components of body tissues and are physiologically compatible to body processes for maintenance of life.
2055 E SOUTHERN AVE STE F, Tempe, AZ 85282
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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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2123430

Prototype Health, Inc · Mesa, AZ
Active · expires Dec 19, 2026
CLIA Number03D2123430
Laboratory TypePhysician Office
Certificate Effective DateDecember 20, 2024
Certificate Expiration DateDecember 19, 2026
Laboratory DirectorJami Kupperman
Laboratory Phone(480) 999-1717
Laboratory LocationPrototype Health, Inc205 E Southern Ave, #103, Mesa, AZ 85210
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

WALKIRIA DAIRIS MARTE-TAVERAS ND
Naturopath
2055 E SOUTHERN AVE STE F
TEMPE, AZ 85282
Maricopa County (480) 999-1717
DR. JAMI KUPPERMAN N.D.
Naturopath
2055 E SOUTHERN AVE STE F
TEMPE, AZ 85282
Maricopa County (480) 829-7829

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 Prototype Health, Inc's NPI number?

The NPI number for Prototype Health, Inc is 1861165144. It was assigned to this organization in the NPPES registry on July 31, 2021.

Where is Prototype Health, Inc located?

Prototype Health, Inc is located at 2055 E Southern Ave Ste F, Tempe, AZ 85282. The listed phone number is (480) 999-1717.

What is Prototype Health, Inc's specialty?

The primary specialty registered for this NPI is Naturopath with taxonomy code 175F00000X.

Does Prototype Health, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2123430) is associated with this NPI, valid through December 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Prototype Health, Inc was last updated on August 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.