Carli Nicole Pruitt, PSY.D., J.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS018963 Issued in PA

Practice address

3001 Hospital Dr
Cheverly, MD 20785-1189

Phone

(301) 618-2000

NPI assigned

Dec 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dimensions Healthcare Associates, IncGroup PAC ID 1557269743, 198 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of MD Capital Region Medical Center Hospital, Upper Marlboro, MD, CCN 210003

Medicare enrollment (NPD)

Enrolled

Credentials

Juris Doctor

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.

• Dimensions Healthcare Associates, Inc.

  • Anesthesiology Physician
  • Largo, MD
  • NPI 1346354834

  DC

  Medicare reassignment Care Compare group NPD
• Premier Health Care, LLC

  • Psychiatry Physician
  • Silver Spring, MD
  • NPI 1285017822

  DC

  Medicare reassignment NPD
• Dimensions Health Associates Dba University of Maryland Capital Region

  • Internal Medicine Physician
  • Oxon Hill, MD
  • NPI 1407486293
  NPD
• Dimensions Healthcare Associates Inc

  • Obstetrics & Gynecology Physician
  • Laurel, MD
  • NPI 1407916646
  NPD
• Premier Health Care LLC

  • Internal Medicine Physician
  • Clinton, MD
  • NPI 1528538758
  NPD
• Premier Health Care LLC

  • Psychiatry Physician
  • Silver Spring, MD
  • NPI 1871962548
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dimensions Health Corporation

  • General Acute Care Hospital
  • Upper Marlboro, MD
  • NPI 1720099286
  Care Compare affiliation

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1053950949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 DAIRY RD",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186035819",
            "telephone_number": "570-594-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DR",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "207851189",
            "telephone_number": "301-618-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3512 Quentin Rd",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112344244",
            "country_code": "US",
            "telephone_number": "800-275-3242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "CARLI",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D., J.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-26",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS018963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Cheverly, MD
• Providers in Cheverly, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.