Stephen Mark Pruni III, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1413 Issued in OH

Practice address

3026 N Wooster Ave
Dover, OH 44622-9469

Phone

(330) 364-4400

Fax

(330) 364-1407

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pruni Chiropractic

  • Chiropractor
  • Dover, OH
  • NPI 1992923536
  NPD Authorized official
• Pruni Chiropractic LLC

  • Chiropractor
  • Dover, OH
  • NPI 1962890400
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942235478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3026 N WOOSTER AVE",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446229469",
            "telephone_number": "330-364-4400",
            "fax_number": "330-364-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3026 N WOOSTER AVE",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446229469",
            "telephone_number": "330-364-4400",
            "fax_number": "330-364-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUNI",
        "first_name": "STEPHEN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0813294",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellen Klepzig Potts, D.O.
• Myrissa Powell, MSW, LSW
• Brenda Sue Prince, D.O.
• Pruni Chiropractic
• Pruni Chiropractic LLC
• Samantha Quillen, CNP
• Annabelle Raber
• Karenann Edith Rader, BGS
• Radiology and Imaging Services, Inc
• Rancho Dialysis LLC

• Chiropractor in Dover, OH
• Providers in Dover, OH by specialty
• Chiropractor in Ohio

• 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.

Verify at the official NPI Registry.