Active NPI
Kimberley Layne Benton Pruitt, PSY.D.
- Psychologist
- Raleigh, NC
National Provider Identifier
1053644070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 5077
- Practice address
- 8506 Six Forks Rd Ste 104
Raleigh, NC 27615-3260 - Phone
- (919) 234-7247
- Fax
- (919) 238-1970
- NPI assigned
- Sep 9, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 5077 | NC | Primary |
Addresses
Primary practice location
8506 Six Forks Rd Ste 104
Raleigh, NC 27615-3260
Mailing address
8506 Six Forks Rd Ste 104
Raleigh, NC 27615-3260
Phone (919) 234-7247
Other names 1
- Dr. Kimberley Layne Benton
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5077 | NC | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oak City Psychology, PLLC | Multi-Specialty | Current | Accepting new patients |
Organizations & group practices 1
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": "1252454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682553600000",
"number": "1053644070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8506 SIX FORKS RD STE 104",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276153260",
"telephone_number": "919-234-7247",
"fax_number": "919-238-1970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8506 SIX FORKS RD STE 104",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276153260",
"telephone_number": "919-234-7247",
"fax_number": "919-238-1970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUITT",
"first_name": "KIMBERLEY",
"middle_name": "LAYNE BENTON",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-09",
"last_updated": "2023-04-27",
"certification_date": "2023-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": "NC",
"license": "5077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLEY",
"last_name": "BENTON",
"middle_name": "LAYNE",
"prefix": "DR.",
"credential": "PSY.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Raleigh, NC
- Provision Solutions, LLC
- Provision Solutions, LLC
- Savannah Addison Pruden, AGNP
- Jessica Ely Prue, PA-C
- Janine Andrea Pruitt
- Pruitthealth - Raleigh, LLC
- Pruitthealth - Raleigh, LLC (PruittHealth - Raleigh)
- Pruitthealth Home Health, Inc. (PruittHealth @ Home - Wake)
- Pruittplace - Whitaker Glen, LLC
- Jennifer R Pruter
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.