Active NPI
Bruce Welton Pratte, O.D.
- Optometrist
- Springfield, OH
National Provider Identifier
1730108283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2836/T601
- Practice address
- 1674 N Limestone St
Springfield, OH 45503-2652 - Phone
- (937) 322-6411
- Fax
- (937) 399-2346
- NPI assigned
- Jul 18, 2006
- Last updated
- Nov 28, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2836/T601 | OH | Primary |
Addresses
Primary practice location
1674 N Limestone St
Springfield, OH 45503-2652
Mailing address
1674 N Limestone St
Springfield, OH 45503-2652
Phone (937) 322-6411
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000005257 | Other | OH | ANTHEM BLUE CROSS BLUE SH |
| 0134367 | Medicaid | OH | |
| 2220168 | Other | OH | UNITED HEALTH CARE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2836/T601 | OH | MD | Optometrist |
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": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322438400000",
"number": "1730108283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1674 N LIMESTONE ST",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455032652",
"telephone_number": "937-322-6411",
"fax_number": "937-399-2346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1674 N LIMESTONE ST",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455032652",
"telephone_number": "937-322-6411",
"fax_number": "937-399-2346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATTE",
"first_name": "BRUCE",
"middle_name": "WELTON",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2011-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "2836/T601",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE SH",
"identifier": "000000005257",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0134367",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "2220168",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.