Active NPI
Thomas Carl Pruett, MD
- Emergency Medicine Physician
- Riverton, WY
National Provider Identifier
1891804779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- WY 2930A
- Practice address
- 2300 Rose LN
Riverton, WY 82501-2257 - Phone
- (307) 857-1211
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | WY 2930A | WY | Primary |
Addresses
Primary practice location
2300 Rose LN
Riverton, WY 82501-2257
Mailing address
534 N Fork Rd
Lander, WY 82520-9108
Phone (307) 332-2434
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WY 2930A | WY | MD | Emergency Medicine Physician |
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": "1183852800000",
"number": "1891804779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "534 N FORK RD",
"city": "LANDER",
"state": "WY",
"postal_code": "825209108",
"telephone_number": "307-332-2434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 ROSE LN",
"city": "RIVERTON",
"state": "WY",
"postal_code": "825012257",
"telephone_number": "307-857-1211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUETT",
"first_name": "THOMAS",
"middle_name": "CARL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WY",
"license": "WY 2930A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverton, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.