Mark Pruitt, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

O-1105 Issued in ID

Practice address

6640 Kaniksu St
Bonners Ferry, ID 83805

Phone

(208) 267-3141

NPI assigned

Jun 19, 2014

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

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Emergency Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boundary Community HospitalGroup PAC ID 3274583406, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boundary Community Hospital Hospital, Bonners Ferry, ID, CCN 131301

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Boundary Community Hospital

  • Critical Access Hospital
  • Bonners Ferry, ID
  • NPI 1801896683
  Medicare reassignment Care Compare group NPD
• Boundary Community Hospital

  • Rural Health Clinic/Center
  • Bonners Ferry, ID
  • NPI 1801273552
  NPD
• Pend Oreille County Public Hospital District No 1

  • Community/Retail Pharmacy
  • Newport, WA
  • NPI 1134831415
  NPD
• Pend Oreille County Public Hospital District No 1

  • Emergency Medicine Physician
  • Newport, WA
  • NPI 1427264795
  NPD
• Pend Oreille County Public Hospital District No 1

  • Clinic/Center
  • Newport, WA
  • NPI 1720294002
  NPD
• Boundary Community Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bonners Ferry, ID
  • NPI 1679621098
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Boundary Community Hospital

  • Critical Access Hospital
  • Bonners Ferry, ID
  • NPI 1801896683
  Care Compare affiliation

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1124432943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6640 KANIKSU ST",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838057532",
            "telephone_number": "208-267-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 KANIKSU ST",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "83805",
            "telephone_number": "208-267-3141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "714 W Pine St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "WA",
            "postal_code": "991569046",
            "country_code": "US",
            "telephone_number": "509-447-2441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "MARK",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "O-1105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jeffrey Petersen, PT
• Jeanne B Racer, LCSW
• Rachel Meiland Webster
• Rawlings Community Counseling
• Rawlings Community Counseling
• Rawlings Community Counseling

• Emergency Medicine Physician in Bonners Ferry, ID
• Providers in Bonners Ferry, ID by specialty
• Emergency Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.