ANDREW L PRUITT (NPI# 1194707745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194707745 |
| Entity Type | Individual |
| Full Name | ANDREW L PRUITT |
| Credential | P.A. |
| Practice Address |
311 Mapleton Ave Boulder CO 80304-3979 |
| Mailing Address |
345 Maxwell Ave Boulder CO 80304-3972 |
| Practice Telephone | 3035445700 |
| Practice Fax Number | 3035445710 |
| Mailing Telephone | 3035445783 |
| Mailing Fax Number | 3034412388 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2013-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 178 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 07178007 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750377206 | Andrew Lee Pruitt | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5325 Elliott Dr, Suite 102, Ypsilanti, MI 48197-8633 | 2005-09-21 |
| Street Address |
311 MAPLETON AVE |
| City | BOULDER |
| State | CO |
| Zip Code | 80304-3979 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225425275 | Crystal Delker | Occupational Therapist | 311 Mapleton Ave, Boulder, CO 80304-3979 | 2015-04-16 |
| 1972999886 | Ana Antonetti | Occupational Therapist | 311 Mapleton Ave, Boulder, CO 80304-3979 | 2015-04-08 |
| 1457755035 | Shannon Aberton | Specialist/Technologist | 311 Mapleton Ave, Boulder, CO 80304-3979 | 2014-10-10 |
| 1457753683 | Denise Knutson | Specialist/Technologist | 311 Mapleton Ave, Boulder, CO 80304-3979 | 2014-09-18 |
| 1124457304 | Fatina Hindi | Counselor | 311 Mapleton Ave, Boulder, CO 80304-3979 | 2013-11-07 |
| 1669801296 | Sonja Stilp, M.d., P.C. | Pain Medicine | 311 Mapleton Ave, Boulder, CO 80304-3979 | 2013-11-04 |
| 1831523984 | Ruth Stephanie Waller | Physical Therapist | 311 Mapleton Ave, Boulder, CO 80304-3979 | 2013-08-26 |
| 1245662949 | Kristine Nichole Rabin | Physical Therapist | 311 Mapleton Ave, Boulder, CO 80304-3979 | 2013-08-05 |
| 1568809291 | Suzanne Segalowitz | Physical Therapist | 311 Mapleton Ave, Boulder, CO 80304-3979 | 2013-06-04 |
| 1184964645 | Brian P Briggs | Physical Therapist | 311 Mapleton Ave, Boulder, CO 80304-3979 | 2013-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1760038723 | Patrica Anne Zeyher | Counselor | 100 Alpine Ave., Boulder, CO 80304 | 2019-08-15 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1831608603 | Lesley Ann Cloke | Dietitian, Registered | 1895 Bluff St., Unit C, Boulder, CO 80304 | 2017-09-25 |
| 1790209740 | Megan Litwiller | Occupational Therapist | 810 Maxwell Ave, Boulder, CO 80304 | 2017-08-01 |
| 1285163774 | Nadine Martin | Registered Nurse | 311 Mapleton Ave # 331, Boulder, CO 80304 | 2017-06-08 |
| 1598119281 | Megan Cronin Larson | Social Worker | 825 S. Broadway Street, Boulder, CO 80304 | 2016-04-19 |
| 1760844237 | Rafia Rebeck | Counselor | 1235 Elder Ave #7, Boulder, CO 80304 | 2016-03-24 |
| 1629441688 | Jennifer S Delaney | Counselor | 2334 Broadway, Ste. B, Boulder, CO 80304 | 2015-11-12 |
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| Find all providers in zip 80304 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750980298 | Rachel Wolfe | Physician Assistant | 38 Qualla Ct, Boulder, CO 80303-3900 | 2020-10-24 |
| 1568005510 | Haley Reiter | Physician Assistant | 5387 Manhattan Cir Ste 201, Boulder, CO 80303-4283 | 2019-10-22 |
| 1326515487 | Kathryn Desellem Devlin | Physician Assistant | 4222 Monroe Dr Apt D, Boulder, CO 80303-2189 | 2018-10-26 |
| 1396244836 | Trisha Quon | Physician Assistant | 4743 Arapahoe Ave Ste 102, Boulder, CO 80303-1123 | 2018-02-11 |
| 1992152482 | Hillary Smyth | Physician Assistant | 75 Manhattan Dr Ste 208, Boulder, CO 80303-4252 | 2016-05-16 |
| 1093180341 | Melissa Ortega | Physician Assistant | 565 Manhattan Dr, 102, Boulder, CO 80303-4051 | 2015-12-10 |
| 1265853790 | David James Mackey | Physician Assistant | 565 Hartford Dr, Boulder, CO 80305-5714 | 2013-12-31 |
| 1023381993 | Ara Rustad Haupt | Physician Assistant | 75 Manhattan Dr Mindful Pediatrics, Suite #4, Boulder, CO 80303 | 2012-02-22 |
| 1336339894 | Amanda Lauren Lapointe | Physician Assistant | 3434 47th St Ste 200, Boulder, CO 80301-1817 | 2007-07-30 |
| 1487855763 | Monica R Giamellaro | Physician Assistant | 1155 Alpine Ave Ste 280, Boulder, CO 80304-3493 | 2007-05-31 |
| Find all providers in BOULDER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.