NPIMap

Individual provider Active NPI

Nicole Pruett

  • Occupational Therapist
  • Surprise, AZ
National Provider Identifier
1033763750
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH-007846 Issued in AZ
Practice address
15802 N Parkview PL
Surprise, AZ 85374-7466
Phone
(623) 876-7000
NPI assigned
Jul 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTH-007846 AZ Primary

Addresses

Primary practice location

15802 N Parkview PL
Surprise, AZ 85374-7466

Mailing address

15802 N Parkview PL
Surprise, AZ 85374-7466
Phone (623) 876-7000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nicole.pruett@dysart.org
Direct Messaging Address nicole.pruett@dysart.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTH-007846AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dysart Unified School District PastSince Aug 6, 2019 Accepting new patients
Dysart Unified School District PastSince Aug 6, 2019 Accepting new patients
RL Speech Therapy, Apc Occupational Therapist Past Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1033763750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15802 N PARKVIEW PL",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747466",
            "telephone_number": "623-876-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15802 N PARKVIEW PL",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747466",
            "telephone_number": "623-876-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-007846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole.pruett@dysart.org",
            "affiliation": "N",
            "address_1": "15802 N Parkview Pl",
            "city": "Surprise",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853747466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole.pruett@dysart.org",
            "affiliation": "N",
            "address_1": "15802 N Parkview Pl",
            "city": "Surprise",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853747466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.