NPIMap

Individual provider Active NPI

Cherish Joy Prutzman, M.D

  • Internal Medicine Physician
  • Centerville, OH
National Provider Identifier
1811907603
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.088432 Issued in OH
Practice address
7073 Clyo Rd
Centerville, OH 45459-4816
Phone
(937) 435-5857
Fax
(937) 912-4960
NPI assigned
Aug 8, 2006
Last updated
Jan 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 55140 MN
Internal Medicine Physician 207R00000X 35.088432 OH Primary

Addresses

Primary practice location

7073 Clyo Rd
Centerville, OH 45459-4816

Mailing address

29 Kyle Dr
Cedarville, OH 45314-9580
Phone (937) 767-7291

Other identifiers 2

IdentifierTypeStateIssuer
2680755MedicaidOH
887642100MedicaidMN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cprutzman191587@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060908000121 OH Practitioner - Internal Medicine 9537163464 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Ohio, Inc Internal Medicine CurrentSince Sep 1, 2014 Accepting new patients
Alliance Physicians Inc Internal Medicine Current Accepting new patients
High-Day, LLC Past Accepting new patients
Sycamorespring Health Care and Rehabilitation LLC Past Accepting new patients
Trilogy Healthcare of Miamisburg, LLC Past Accepting new patients
Astoria Healthcare Group, LLC Past Accepting new patients
Greene Memorial Hospital, Inc. Past Accepting new patients
CT Ohio Dayton-Centerville LLC Past Accepting new patients
Inpatient Consultants of Michigan PC Internal Medicine Past Accepting new patients
Vancrest of New Carlisle, LLC Past Accepting new patients
Hillspring Health Care Center, LLC Past Accepting new patients
Kingston of Miamisburg, LLC Past Accepting new patients

Locations

36123 Schoolcraft Rd
Livonia, MI 48150
Phone (734) 793-6140

29 Kyle Dr
Cedarville, OH 45314
Phone (937) 766-2611

7073 Clyo Rd
Dayton, OH 45459
Phone (937) 435-5857

4790 Cottonville Rd
Jamestown, OH 45335
Phone (937) 675-2870

2115 Leiter Rd
Ste 300
Miamisburg, OH 45342
Phone (937) 866-7469

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

888 Dayton St
Unit 200
Yellow Springs, OH 45387
Phone (937) 767-7291

Interoperability endpoints

  • Direct secure messaging: cprutzman191587@direct.ketteringhealth.org

Ownership & related parties

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kettering Health HamiltonHamilton, OH, CCN 360132 Hospital Corporate Director Jan 31, 2024
Kettering Health Greene MemorialXenia, OH, CCN 360026 Hospital Corporate Director Jan 31, 2024
Kettering Health DaytonDayton, OH, CCN 360133 Hospital Corporate Director Jan 31, 2024
Kettering Health MiamisburgMiamisburg, OH, CCN 360239 Hospital Corporate Director Jan 31, 2024
Soin Medical CenterBeavercreek, OH, CCN 360360 Hospital Corporate Director Jan 31, 2024
Kettering Health TroyTroy, OH, CCN 360368 Hospital Corporate Director Jan 31, 2024
KH Hamilton Inpatient Rehab UnitHamilton, OH, CCN 36T132 Hospital Corporate Director Jan 31, 2024
Kettering Health Primary Care, a Service of Kettering Health Greene MeYellow Springs, OH, CCN 363401 Rural health clinic Corporate Director May 1, 2020
Kettering Health Primary Care, a Service of Kettering Health Greene MeCedarville, OH, CCN 363400 Rural health clinic Corporate Director May 1, 2020
Kettering Health Primary Care, a Service of Kettering Health Greene MeJamestown, OH, CCN 363428 Rural health clinic Corporate Director Jan 31, 2024
Kettering Health Primary Care, a Service of Soin Medical CenterWilmington, OH, CCN 363438 Rural health clinic Corporate Director May 1, 2020

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1811907603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 KYLE DR",
            "city": "CEDARVILLE",
            "state": "OH",
            "postal_code": "453149580",
            "telephone_number": "937-767-7291",
            "fax_number": "937-767-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7073 CLYO RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594816",
            "telephone_number": "937-435-5857",
            "fax_number": "937-912-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUTZMAN",
        "first_name": "CHERISH",
        "middle_name": "JOY",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "55140",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.088432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2680755",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887642100",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cprutzman191587@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "29 Kyle Dr",
            "city": "Cedarville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453149580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "29 Kyle Dr",
            "city": "Cedarville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453149580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

Verify at the official NPI Registry.