DR. MATTHEW SCOTT PRUITT (NPI# 1851673388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851673388 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW SCOTT PRUITT |
| Credential | PHARMD |
| Practice Address |
1919 W Pioneer Pkwy Peoria IL 61615-1825 |
| Mailing Address |
318 N Kickapoo Ter Peoria IL 61604-5430 |
| Practice Telephone | 3096920045 |
| Mailing Telephone | 3093692762 |
| Enumeration Date | 2011-09-10 |
| Last Update Date | 2011-09-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051-294490 | IL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023475878 | Matthew H Pruitt | Physician Assistant | 1 Medical Park Dr, Benton, AR 72015-3353 | 2016-01-25 |
| Street Address |
1919 W PIONEER PKWY |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-1825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518972736 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1919 W Pioneer Pkwy, Peoria, IL 61615-1825 | 2006-07-29 |
| 1750981676 | Ahmad Wehbi | Pharmacist | 1919 W Pioneer Pkwy, Peoria, IL 61615-1854 | 2020-10-29 |
| 1366049850 | Faryal Tariq | Pharmacist | 1919 W Pioneer Pkwy, Peoria, IL 61615-1854 | 2020-10-07 |
| 1306464839 | Sherin Oommen | Pharmacist | 1919 W Pioneer Pkwy, Peoria, IL 61615-1825 | 2020-07-10 |
| 1821616459 | Robert Mark Antonacci | Pharmacist | 1919 W Pioneer Pkwy, Peoria, IL 61615-1825 | 2020-07-09 |
| 1891161485 | Danielle Cramarosso | Pharmacist | 1919 W Pioneer Pkwy, Peoria, IL 61615-1825 | 2015-08-18 |
| 1912383548 | Danielle E Schneider | Pharmacist | 1919 W Pioneer Pkwy, Peoria, IL 61615-1825 | 2015-08-05 |
| 1124428586 | Rachel Rice | Pharmacist | 1919 W Pioneer Pkwy, Peoria, IL 61615-1825 | 2014-09-03 |
| 1215363585 | Roger George Kurian | Pharmacist | 1919 W Pioneer Pkwy, Peoria, IL 61615-1825 | 2013-09-18 |
| 1083056162 | Jisha M John | Pharmacist | 1919 W Pioneer Pkwy, Peoria, IL 61615-1825 | 2013-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245397 | Lynsey Perera | Pharmacist | 7610 N Orange Prairie Rd, Peoria, IL 61615-9324 | 2020-11-05 |
| 1699375683 | Christopher Wayne Sharp | Pharmacist | 8062 W Eva St, Peoria, AZ 85345-7197 | 2020-10-28 |
| 1760093413 | Andrea Stump | Pharmacist | 24865 N Lake Pleasant Pkwy, Peoria, AZ 85383-1280 | 2020-08-14 |
| 1154957926 | Bhumit Kalavadiya | Pharmacist | 8375 W Pontiac Dr, Peoria, AZ 85382-1412 | 2020-03-12 |
| 1386290518 | Taylor Naberhaus | Pharmacist | 13640 N Plaza Del Rio Blvd # 210, Peoria, AZ 85381-4846 | 2019-08-13 |
| 1043767106 | Jason Mcaddley | Pharmacist | 9425 West Union Hills Drive, Peoria, AZ 85382 | 2016-09-07 |
| 1801263579 | John Leano | Pharmacist | 26898 N 87th Dr, Peoria, AZ 85383 | 2015-08-28 |
| 1245638782 | Adam Browning | Pharmacist | 12456 W Milton Dr, Peoria, AZ 85383-5009 | 2014-12-16 |
| 1447664784 | Rusvel Villamarin Santacruz | Pharmacist | 9313 W Ross Ave, Peoria, AZ 85382-5237 | 2014-06-15 |
| 1811300684 | Edward Monroe | Pharmacist | 316 W Ridgemont Rd, Peoria, IL 61614-7222 | 2014-06-09 |
| Find all providers in PEORIA | ||||
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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.