Thomas Ernest Pryor, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M7337 Issued in ID

Practice address

121 5TH Ave West
Gooding, ID 83330

Phone

(208) 934-4800

Fax

(208) 934-9611

NPI assigned

Nov 6, 2006

Last updated

Dec 15, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Gooding County Hospital District

  • Critical Access Hospital
  • Gooding, ID
  • NPI 1295769537
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1861561094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 5TH AVE WEST",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "83330",
            "telephone_number": "208-934-4800",
            "fax_number": "208-934-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 5TH AVE WEST",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "83330",
            "telephone_number": "208-934-4800",
            "fax_number": "208-934-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYOR",
        "first_name": "THOMAS",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M7337",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2011020656",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "46233",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805049900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Lee Petty
• Christina Ann Pickett, RDN, LD
• Pro Active Advantage, LLC (Pro Active Behavioral Health)
• Pro Active Advantage, LLC (Pro Active Behavioral Health)
• Pro Active Advantage, LLC (Pro Active Behavioral Health)
• Austin Heath Rasmussen, PA-C
• Raymond C. Goodman, O.D., P.a. (Eyecare Center of Gooding PA)
• Carmalin S Resz
• Ridley's Family Markets, Inc (Ridley's Pharmacy #8445)
• Kacey Rindlisbacher

• Family Medicine Physician in Gooding, ID
• Providers in Gooding, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.

Verify at the official NPI Registry.