Peter T Prutch, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

1906 Issued in CO

Practice address

2121 S Oneida St
248
Denver, CO 80224-2549

Phone

(303) 504-0600

Fax

(303) 504-0601

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Family Centered Medicine, Inc

  • General Practice Physician
  • Denver, CO
  • NPI 1972773232
  Medicare reassignment NPD Authorized official
• Pinnacle Pediatrics and Internal Medicine Professional LLC

  • Primary Care Clinic/Center
  • Westminster, CO
  • NPI 1871018085
  Medicare reassignment NPD

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1497792543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 S ONEIDA ST",
            "address_2": "248",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802242549",
            "telephone_number": "303-504-0600",
            "fax_number": "303-504-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 S ONEIDA ST",
            "address_2": "248",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802242549",
            "telephone_number": "303-504-0600",
            "fax_number": "303-504-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUTCH",
        "first_name": "PETER",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "70254",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "1906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15883825",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Rae Pruess, MA, BCBA
• Katelyn Marie Pruett, MD, MPH
• Christian Jacob Pruitt, DO
• Katherine M Pruitt, LPC
• Wesley Ryan Pruitt
• Elizabeth Jane Pryor, R.N. B.S.N
• Joseph Brian Pryor
• Mary Ann Pryor, CAC1, CMT
• Peter W Pryor, MD
• Sidnie Pryor

• Adult Health Nurse Practitioner in Denver, CO
• Providers in Denver, CO by specialty
• Adult Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.