Ivy Pruss

Primary specialty

NaturopathTaxonomy code 175F00000X

Practice address

1402 S Park Loop Rd
Jackson, WY 83001-9500

Phone

(307) 690-7603

NPI assigned

Jan 26, 2021

Last updated

Jan 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1255921987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 S PARK LOOP RD",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830019500",
            "telephone_number": "307-690-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S PARK LOOP RD",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830019500",
            "telephone_number": "307-690-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSS",
        "first_name": "IVY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hello@epigenetichealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1402 S Park Loop Rd",
            "city": "Jackson",
            "state": "WY",
            "country_code": "US",
            "postal_code": "830019500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brian Charles Prax, MA PT
• Madison Prescott, RBT
• Natalie Prescott, MS, PPC
• Rosanne Prince, AU.D., CCC/A
• Jason D Provus, MD
• Carrie Ross Quinlan, FNP-C
• Joseph W. Raboin, CRNA
• Aimee M Racette, CRNA
• Rathna Raju-Swami, MD
• William John Ramsay III, M.D.

• Naturopath in Jackson, WY
• Providers in Jackson, WY by specialty
• Naturopath in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.