Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Prohealth Medical Group Inc

Organization General Practice Physician · NPI 1417627514

Prohealth Medical Group Inc is a General Practice Physician in Waterford, Wisconsin. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

808 Cornerstone Ct
Waterford, WI 53185-4562
Phone: (262) 928-1977
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1417627514
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProhealth Medical Group Inc
Authorized official Thomas Johnson — Reimbursement Manager · (262) 928-4704
NPI enumeratedSeptember 20, 2021
Last updated in NPPESJanuary 22, 2025
Certification dateJanuary 22, 2025
Mailing addressN17w24100 Riverwood Dr, Waukesha, WI 53188-1127