Individual provider Active NPI

Christopher Pruitt, PA

  • Medical Physician Assistant
  • Casper, WY
National Provider Identifier
1629800032
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA1408 Issued in WY
Practice address
1300 Venture Way Ste 206
Casper, WY 82609-4353
Phone
(307) 268-9904
NPI assigned
Aug 14, 2024
Last updated
Feb 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA1408 WY Primary

Addresses

Primary practice location

1300 Venture Way Ste 206
Casper, WY 82609-4353

Mailing address

1300 Venture Way Ste 206
Casper, WY 82609-4353
Phone (307) 268-9904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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

Enrollment IDStateProvider typePAC IDDetails
I20251205003467 WY Practitioner - Physician Assistant 3274026349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1300 Venture Way
Suite 206
Casper, WY 82609-4353

34406 53Rd Ave S
Auburn, WA 98001-9709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1408WYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ms Holdings, LLC CurrentSince Oct 26, 2025 Accepting new patients

Locations

1300 Venture Way
Ste 206
Casper, WY 82609
Phone (307) 268-9904

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1629800032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 VENTURE WAY STE 206",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094353",
            "telephone_number": "307-268-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 VENTURE WAY STE 206",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094353",
            "telephone_number": "307-268-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "CHRISTOPHER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-14",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "PA1408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.