ROSEANN PRUITT PA-C ATC NPI 1114304284

NPI Information

NPI: 1114304284
Provider Name: ROSEANN PRUITT, PA-C, ATC
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
1762 CLIFTON RD NE
STE 1650
ATLANTA, GA
ZIP 30322
Phone: (978) 618-7329
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Roseann Pruitt, PA-C, ATC is a medical physician assistant in Atlanta, GA with 6 years of experience. Roseann Pruitt, PA-C, ATC NPI is 1114304284. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2018

The provider's business location address is:

1762 CLIFTON RD NE
STE 1650
ATLANTA, GA
ZIP 30322-001
Phone: (978) 618-7329

The NPI 1114304284 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/28/2015 and was last updated on 3/10/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2255A2300X	Specialist/Technologist	Athletic Trainer	AT001944	GEORGIA	No
2	363A00000X	Physician Assistant			GEORGIA	No
3	363AM0700X	Physician Assistant	Medical	9174	GEORGIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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