DR. VINCENT R PRUSICK (NPI# 1922022888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922022888 |
| Entity Type | Individual |
| Full Name | DR. VINCENT R PRUSICK |
| Credential | M.D. |
| Practice Address |
4045 W Royal Dr Traverse City MI 49684-8965 |
| Practice Telephone | 2319350900 |
| Practice Fax Number | 2319350308 |
| Mailing Telephone | 2319350900 |
| Mailing Fax Number | 2319350308 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
4301044833 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902164411 | Vincent Prusick | Orthopaedic Surgery | 110 Conn Ter, Lexington, KY 40508 | 2012-05-03 |
| Street Address |
4045 W ROYAL DR |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-8965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336141704 | Jeff Philip Burke | Physical Therapist | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2005-08-15 |
| 1417563073 | Madeline Adams | Nurse Practitioner | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2020-09-18 |
| 1043845928 | Kolleen Werly | Physician Assistant | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2020-03-11 |
| 1821599374 | Spencer Popp | Physician Assistant | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2018-02-21 |
| 1851832844 | Danielle Muszynski | Nurse Practitioner | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2017-03-10 |
| 1902233471 | Trisha Rae Zelinski | Physician Assistant | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2013-09-30 |
| 1124316096 | Janice Mary Cobb | Physical Therapist | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2011-07-13 |
| 1952691768 | Alisha Marie Cole | Physician Assistant | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2011-04-13 |
| 1306154505 | Karen Allison Miller | Specialist/Technologist | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2010-09-22 |
| 1114232279 | Shelly R King | Physical Therapy Assistant | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2010-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144650391 | Accuspine Pllc | Orthopaedic Surgery | 612 Park St, Birmingham, MI 48009-3424 | 2013-11-24 |
| 1669809612 | Michigan Orthopaedic Spine Surgeons PC | Orthopaedic Surgery | 29624 Woodward Ave, Royal Oak, MI 48073-0905 | 2013-10-07 |
| 1376808105 | Lucent Spine, Pllc | Orthopaedic Surgery | 2300 Haggerty Rd Ste 2100, West Bloomfield, MI 48323-2191 | 2012-07-09 |
| 1033143052 | Jeffrey K. Wingate, M.d. | Orthopaedic Surgery | 13355 East Ten Mile Road, Medical Office Building East Ste. 115, Warren, MI 48089 | 2006-07-10 |
| 1689605925 | Philip Jeffery Mayer | Orthopaedic Surgery | 9389 N Haggerty Rd, Plymouth, MI 48170-4622 | 2006-07-05 |
| 1235117524 | Jeffrey K Wingate | Orthopaedic Surgery | 555 Barclay Cir Ste 140, Rochester Hills, MI 48307-4587 | 2006-01-06 |
| 1801870266 | Edgar Neil Pasia | Orthopaedic Surgery | 940 River Centre Dr., Port Huron, MI 48060 | 2005-11-30 |
| 1194713669 | Kenneth J Easton | Orthopaedic Surgery | 1111 Leffingwell Ne, Ste 100, Grand Rapids, MI 49525 | 2005-10-10 |
| 1669465761 | John Ernest Lamacchia | Orthopaedic Surgery | 1135 W University Dr Ste 450, Rochester, MI 48307-1871 | 2005-08-24 |
| 1104458181 | Msu Health Care Inc. | Orthopaedic Surgery | 4660 S Hagadorn Rd Ste 500, East Lansing, MI 48823-6804 | 2020-02-07 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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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.