Charles L Pruitt, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35048030 Issued in OH

Practice address

401 N Ewing St
Lancaster, OH 43130-3372

Phone

(740) 687-8000

Fax

(740) 687-8939

NPI assigned

Nov 7, 2005

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 OH

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

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 and National Provider Directory roles.

• Emergency Medicine Physicians of Lancaster, LTD.

  • Emergency Medicine Physician
  • Lancaster, OH
  • NPI 1881025344
  Medicare reassignment NPD
• Fairfield Emergency Physicians Inc

  • Emergency Medicine Physician
  • Lancaster, OH
  • NPI 1598705949
  NPD (past)
• Fairfield ER Physicians Dba Fairfield Medical Center Pro Fee

  • Emergency Medicine Physician
  • Lancaster, OH
  • NPI 1942233879
  NPD (past)

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1194706341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713464",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452710001",
            "telephone_number": "740-687-8990",
            "fax_number": "740-687-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N EWING ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303372",
            "telephone_number": "740-687-8000",
            "fax_number": "740-687-8939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "CHARLES",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35048030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE MEDICAL LICENS",
            "identifier": "35048030",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0867807",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PRN Medical Staffing of Ohio Inc
• Boni J Probasco, LPCC
• Elise M Probasco, QMHS BA CMS BA
• Professional Dental Alliance of Hopewell LLC
• Benjamin E Pruitt, CNP
• Alva Puckett, CPRS
• Elizabeth Pugsley
• Vijay Putherickal, DO
• Mahesh Pydipati, PT
• Andrea Quach, DO

• Emergency Medicine Physician in Lancaster, OH
• Providers in Lancaster, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.