Active NPI
Robert Alan Pratt, D.M.D.
- Dentist
- Nampa, ID
National Provider Identifier
1770692618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D-3499
- Practice address
- 605 W Highland Ave
Nampa, ID 83686-4925 - Phone
- (208) 250-2105
- Fax
- (208) 250-2105
- NPI assigned
- Aug 30, 2006
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D-3499 | ID | Primary |
Addresses
Primary practice location
605 W Highland Ave
Nampa, ID 83686-4925
Mailing address
605 W Highland Ave
Nampa, ID 83686-4925
Phone (208) 442-3078
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 806324400 | Medicaid | ID |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-3499 | ID | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263513600000",
"number": "1770692618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 W HIGHLAND AVE",
"city": "NAMPA",
"state": "ID",
"postal_code": "836864925",
"telephone_number": "208-442-3078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 W HIGHLAND AVE",
"city": "NAMPA",
"state": "ID",
"postal_code": "836864925",
"telephone_number": "208-250-2105",
"fax_number": "208-250-2105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATT",
"first_name": "ROBERT",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2010-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ID",
"license": "D-3499",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806324400",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.