Active NPI
Kimie Michelle Pruessner, P.A.-C.
- Physician Assistant
- Dallas, TX
National Provider Identifier
1851614226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA06535
- Practice address
- 1050 N Westmoreland Rd
#432
Dallas, TX 75211-2444 - Phone
- (214) 333-3033
- Fax
- (214) 330-2163
- NPI assigned
- Mar 12, 2010
- Last updated
- Mar 12, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA06535 | TX | Primary |
Addresses
Primary practice location
1050 N Westmoreland Rd
#432
Dallas, TX 75211-2444
Mailing address
1050 N Westmoreland Rd
#432
Dallas, TX 75211-2444
Phone (214) 333-3033
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268352000000",
"number": "1851614226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 N WESTMORELAND RD",
"address_2": "#432",
"city": "DALLAS",
"state": "TX",
"postal_code": "752112444",
"telephone_number": "214-333-3033",
"fax_number": "214-330-2163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 N WESTMORELAND RD",
"address_2": "#432",
"city": "DALLAS",
"state": "TX",
"postal_code": "752112444",
"telephone_number": "214-333-3033",
"fax_number": "214-330-2163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUESSNER",
"first_name": "KIMIE",
"middle_name": "MICHELLE",
"credential": "P.A.-C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-12",
"last_updated": "2010-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA06535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; 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.