KENNETH H. PRUSHIK (NPI# 1740290162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740290162 |
| Entity Type | Individual |
| Full Name | KENNETH H. PRUSHIK |
| Credential | M.D. |
| Practice Address |
1994 Wellness Blvd Ste 110 Monroe NC 28110-7768 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043848460 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 2018-00935 | NC | Allopathic & Osteopathic Physicians |
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
228253-1 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | HEALTHNET | 3C3318 | 01 |
| NY | BLUE CROSS/ BLUE SHIELD | 556Y51 | 01 |
| NY | 02461633 | 05 | |
| NY | GHI | 0600898 | 01 |
| NY | OXFORD | P2939540 | 01 |
| Street Address |
1994 WELLNESS BLVD STE 110 |
| City | MONROE |
| State | NC |
| Zip Code | 28110-7768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932128394 | Mary L Lindsay-barber | Pediatrics | 1994 Wellness Blvd Ste 110, Suite 110, Monroe, NC 28110-7768 | 2006-07-18 |
| 1598857625 | Erin L. Washburn | Pediatrics | 1994 Wellness Blvd Ste 110, Monroe, NC 28110-7768 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164987996 | Austin Drugs, Inc | Pharmacy | 3513 Suite B Highway 74 E, Monroe, NC 28110 | 2019-02-06 |
| 1366922353 | First Choice Supply, Inc | Clinic/Center | 2909 Waycross Dr, Monroe, NC 28110 | 2018-08-19 |
| 1235616491 | Joshua Gibbons | Physical Therapist | 1999 Wellness Blvd., Suite 220, Monroe, NC 28110 | 2018-07-20 |
| 1508356940 | Latoya I Sheppard | Prosthetist | 1643 Hilton Meadow Dr, Monroe, NC 28110 | 2018-05-11 |
| 1598266546 | Healthstat Onsite Clinic Conmet Monroe 1 | Preventive Medicine | 780 Patterson Avenue, Monroe, NC 28110 | 2018-02-26 |
| 1801397864 | Healthstat Onsite Con Met Monroe 2 | Preventive Medicine | 4515 Corporate Center Drive, Monroe, NC 28110 | 2018-02-26 |
| 1366969834 | Megan Thomas | Nurse Practitioner | 5708 Concord Hwy, Monroe, NC 28110 | 2017-08-25 |
| 1619385168 | Dillon Byrum | Specialist/Technologist | 28110 Eagle View Lane, Monroe, NC 28110 | 2014-07-29 |
| 1932545266 | Shane Markey | Dentist | 2258 W. Roosevelt Blvd, Suite A Dentistry of The Carolinas, Monroe, NC 28110 | 2013-05-14 |
| 1952648644 | Rolanda Johnson Abney | Social Worker | 2661 W Roosevelt Blvd Ste 107, Monroe, NC 28110 | 2013-01-15 |
| Find all providers in zip 28110 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447886155 | Natalie Brown Shumate | Pediatrics | 1669 Pleasant Valley Rd Ne, Monroe, GA 30655-6211 | 2020-03-14 |
| 1902393648 | Morehouse Community Medical Centers, Inc | Pediatrics | 1825 N 18th St Ste A&b, Monroe, LA 71201-4420 | 2018-04-18 |
| 1700261336 | Munira A Yusuf Md | Pediatrics | 1703 Lamy Ln, Monroe, LA 71201-3737 | 2015-07-24 |
| 1366734832 | Francois Hayato Coutu | Pediatrics | 401 Monroe Tpke Ste 16, Monroe, CT 06468-2278 | 2011-05-03 |
| 1407087547 | Flor De Maria Grados Valderrama | Pediatrics | 2802 Pargoud Blvd, Monroe, LA 71201-2335 | 2009-08-06 |
| 1285809731 | Kathleen Reinhart Do PC | Pediatrics | 14930 Laplaisance Rd Ste 127, Monroe, MI 48161-3878 | 2008-04-25 |
| 1851422919 | Monroe Pediatrics | Pediatrics | 218 Martin Luther King Jr Blvd, Monroe, GA 30655-5622 | 2007-03-08 |
| 1386707362 | Munira A Yusuf | Pediatrics | 2829 W Deborah Dr, Monroe, LA 71201-1919 | 2006-12-19 |
| 1114004421 | Barbara Ann Davies | Pediatrics | 1210 Frank Dr, Monroe, MI 48162-3400 | 2006-11-01 |
| 1699850313 | Alan Werzberger | Pediatrics | 22 Van Buren Dr, Suite 102, Monroe, NY 10950-6018 | 2006-10-25 |
| Find all providers in MONROE | ||||
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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.