Active NPI
Ronald William Sproat, MD
- Surgery Physician
- Prineville, OR
National Provider Identifier
1609833987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD12552
- Practice address
- 384 SE Combs Flat Rd
Suite 1200
Prineville, OR 97754-2562 - Phone
- (541) 548-7761
- Fax
- (541) 526-6554
- NPI assigned
- Apr 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD12552 | OR | Primary |
Addresses
Primary practice location
384 SE Combs Flat Rd
Suite 1200
Prineville, OR 97754-2562
Mailing address
PO Box 5579
Bend, OR 97708-5579
Phone (541) 548-7761
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 024744001 | Other | OR | BLUE CROSS |
| 223222 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12552 | OR | MD | Massage Therapist |
Interoperability endpoints
- rsproat17825@secure.stcharleshealthcare.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457395200000",
"number": "1609833987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5579",
"city": "BEND",
"state": "OR",
"postal_code": "977085579",
"telephone_number": "541-548-7761",
"fax_number": "541-526-6554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "384 SE COMBS FLAT RD",
"address_2": "SUITE 1200",
"city": "PRINEVILLE",
"state": "OR",
"postal_code": "977542562",
"telephone_number": "541-548-7761",
"fax_number": "541-526-6554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPROAT",
"first_name": "RONALD",
"middle_name": "WILLIAM",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-28",
"last_updated": "2016-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OR",
"license": "MD12552",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "024744001",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "223222",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prineville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.