Kelly Dean Pridgen, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD24109 Issued in OR

Practice address

1601 SE Court Ave
Pendleton, OR 97801-3217

Phone

(541) 276-5121

Fax

(541) 278-3661

NPI assigned

Jun 3, 2006

Last updated

Mar 5, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

70.94

Improvement activities

40

Cost

92.94

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cep America LLC

  dba Vituity

  • Emergency Medicine Physician
  • Roseburg, OR
  • NPI 1780647719
  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Pendleton, OR
  • NPI 1902673072
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Northwest Physician Associates, Apc

  • Emergency Medicine Physician
  • Federal Way, WA
  • NPI 1407127442
  NPD (past)
• Tacoma Emergency Medicine Associates PC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1134321888
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1013955798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 336TH ST",
            "address_2": "SUITE 600",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036328",
            "telephone_number": "253-838-6180",
            "fax_number": "253-838-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SE COURT AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978013217",
            "telephone_number": "541-276-5121",
            "fax_number": "541-278-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDGEN",
        "first_name": "KELLY",
        "middle_name": "DEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD24109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0224305",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181590",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Praxis Health, PC (Pendleton Family Medicine)
• Praxis Health, PC (Pendleton Urgent Care)
• Praxis Health, PC (Eastern Oregon Orthopaedic Surgery & Fracture Clinic)
• Prestige Residential Community LLC (Elizabethan Manor)
• Jennie Rebecca Price, MS CCC-SLP
• Denise Prinkey
• Katherine Prose
• Trevor Prow
• Psychological Services of Pendleton, LLC
• Heidi Purcell

• Emergency Medicine Physician in Pendleton, OR
• Providers in Pendleton, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.