Michael George Pruner, ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

201394159NP-PP Issued in OR

Practice address

25647 Redwood Hwy
Cave Junction, OR 97523-9332

Phone

(541) 592-4111

Fax

(541) 592-3916

NPI assigned

Mar 7, 2007

Last updated

Nov 18, 2015By 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 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michaelpruner@acmgllc.allscriptsdirect.net

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.

• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Medicare reassignment Care Compare group NPD
• Allcare Medical Group LLC

  • Family Medicine Physician
  • Grants Pass, OR
  • NPI 1699360412
  Medicare reassignment NPD
• Chuluota Clinic, LLC

  • Primary Care Clinic/Center
  • Chuluota, FL
  • NPI 1508119637
  NPD Authorized official
• Sky Lakes Medical Center Inc

  dba Sky Lakes Specialty Pharmacy

  • Community/Retail Pharmacy
  • Klamath Falls, OR
  • NPI 1003654625
  NPD
• Lwafp PC Inc

  dba Living Water Adult Family Practice

  • Adult Health Nurse Practitioner
  • Grants Pass, OR
  • NPI 1992951107
  NPD (past)
• Northwest Family Practice LLC

  dba NorthWest Family Practice (NWFP)

  • Family Medicine Physician
  • Grants Pass, OR
  • NPI 1891347415
  NPD (past)
• Precision Pulmonary NP, Inc.

  dba Precision Pulmonary

  • Nurse Practitioner
  • Dunedin, FL
  • NPI 1811202054
  NPD (past)

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

• Sky Lakes Medical Center Inc

  • Occupational Therapist
  • Klamath Falls, OR
  • NPI 1134270911

  Hospital

  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Care Compare affiliation

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1356472161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 NW HAWTHORNE AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261257",
            "telephone_number": "541-592-4111",
            "fax_number": "541-592-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25647 REDWOOD HWY",
            "city": "CAVE JUNCTION",
            "state": "OR",
            "postal_code": "975239332",
            "telephone_number": "541-592-4111",
            "fax_number": "541-592-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUNER",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 3366972",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "201394159NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP",
            "identifier": "ARNP 3366972",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500676542",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steve Mock, D.M.D.
• James D Nordal, M.D.
• Options for Southern Oregon
• Options for Southern Oregon
• Margaret Philhower, N.D.
• Alexandra Erin Reed, PT, DPT
• Nicole Ann Rensenbrink, LCSW
• Karin Rohland, L.AC.
• Christine Rotin, PAC
• Jocelyn Lee Rousseau, LMT

• Adult Health Nurse Practitioner in Cave Junction, OR
• Providers in Cave Junction, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.