Carly Michele Prutzman, APRN, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

86017 Issued in OK

Practice address

1503 S Mission St Ste a
Anadarko, OK 73005-5815

Phone

(405) 247-1100

Fax

(405) 247-1155

NPI assigned

Oct 12, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carly Michele Pruitt Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OK

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

Interoperability endpoints

• Direct secure messaging: ms_cprutzma@landmarkhealth-direct.org

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.

• Complete Family Wellness and Urgent Care

  • Primary Care Nurse Practitioner
  • Lindsay, OK
  • NPI 1679153548
  NPD (past)
• Healthcare Stat of Lindsay LLC

  • Family Nurse Practitioner
  • Lindsay, OK
  • NPI 1447765086
  NPD (past)

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1790235877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 WINDMILL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731657382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 S MISSION ST STE A",
            "city": "ANADARKO",
            "state": "OK",
            "postal_code": "730055815",
            "telephone_number": "405-247-1100",
            "fax_number": "405-247-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUTZMAN",
        "first_name": "CARLY",
        "middle_name": "MICHELE",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "86017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://ehr.wrshealth.com/",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "1503 S Mission St Ste A",
            "city": "Anadarko",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730055815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "PRUITT",
            "middle_name": "MICHELE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gloria Mae Pocowatchit X
• Levi Japheth Pohocsucut, BS
• Audrey Winnie Poolaw, PHARM.D.
• Sydney Morgan Prince, LCSW
• Harleigh Shaye Pruitt, BHCM II
• Leonicia Natalia Ramirez, NURSE PRACTITIONER
• Reach Out, Inc
• Renal Treatment Centers West Inc
• Rha Anadarko Inc
• Rha Anadarko Inc

• Family Nurse Practitioner in Anadarko, OK
• Providers in Anadarko, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.