Jackson Thomas Pruett, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P19589 Issued in NC

Practice address

5860 Yadkin Rd
Fayetteville, NC 28303-2668

Phone

(910) 491-5164

NPI assigned

Jun 11, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Benchmark Physical Therapy of North Carolina, LLCGroup PAC ID 1052609278, 242 clinicians

Benchmark Healthcare Services LLCGroup PAC ID 3779726468, 136 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Benchmark Healthcare Services, LLC

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1811213341

  SC

  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy of North Carolina LLC

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1356894604

  NC

  Medicare reassignment Care Compare group NPD
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  Physical Therapist, SC

  Medicare reassignment NPD
• Drayer Physical Therapy-South Carolina, LLC

  • Physical Therapist
  • Columbia, SC
  • NPI 1841622354
  Medicare reassignment NPD
• Benchmark Physical Therapy of NC, LLC

  • Physical Therapist
  • Leland, NC
  • NPI 1588189112
  NPD
• Agilitas USA, Inc

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD
• Benchmark Health Services

  • Physical Therapist
  • Easley, SC
  • NPI 1457842643
  NPD
• Benchmark Healthcare Service LLC

  • Physical Therapist
  • Myrtle Beach, SC
  • NPI 1083121594
  NPD
• Drayer Physical Therapy - South Carolina, LLC

  • Physical Therapist
  • Camden, SC
  • NPI 1154816833
  NPD
• Benchmark Health Services, LLC

  • Physical Therapist
  • Rock Hill, SC
  • NPI 1245636323
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1013532498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "953 BUTLER DR",
            "city": "ERWIN",
            "state": "NC",
            "postal_code": "283398519",
            "telephone_number": "919-451-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 YADKIN RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283032668",
            "telephone_number": "910-491-5164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 Celanese Rd Ste 113",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297321757",
            "country_code": "US",
            "telephone_number": "803-366-8243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "JACKSON",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-11",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10968",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prosperity Ridge Enterprises LLC
• Ana Stacia Prosser
• Provisions Behavioral Services
• Michele T Provost, PA
• Renee Mechelle Prows, LPCA
• Lysiane Pruitt, FNP
• Pruitthealth Hospice, Inc.
• Kimberly Wilson Pryzgoda, DDS
• Publix North Carolina LP
• Publix North Carolina LP

• Physical Therapist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.