Active NPI
Dewayne Pruitt, RN, BSN
- Home Health Registered Nurse
- Aliceville, AL
National Provider Identifier
1104571090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- 1-121419
- Practice address
- 2153 Jenkins Road
Aliceville, AL 35442 - Phone
- (205) 367-1619
- Fax
- (205) 367-1619
- NPI assigned
- Feb 18, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 1-121419 | AL | Primary |
Addresses
Primary practice location
2153 Jenkins Road
Aliceville, AL 35442
Mailing address
2111 Jenkins Rd
Aliceville, AL 35442-4931
Phone (205) 367-1619
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000000000 | Other | AL | DONT HAVE ONE |
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
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-121419 | AL | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1104571090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2111 JENKINS RD",
"city": "ALICEVILLE",
"state": "AL",
"postal_code": "354424931",
"telephone_number": "205-367-1619",
"fax_number": "205-367-1619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2153 JENKINS ROAD",
"city": "ALICEVILLE",
"state": "AL",
"postal_code": "35442",
"telephone_number": "205-367-1619",
"fax_number": "205-367-1619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUITT",
"first_name": "DEWAYNE",
"credential": "RN, BSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-18",
"last_updated": "2022-07-21",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "AL",
"license": "1-121419",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DONT HAVE ONE",
"identifier": "0000000000000",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aliceville, AL
- Anna Katherine King
- Niya McCoy
- Christie Miller
- Omega Mobile Wellness LLC
- James L Parker, M.D.
- Christopher Alan Sanders
- Anna Carter Stevens
- Nicholas J. Tolstick IV, DPT
- Whatley Health Services, Inc. (Whatley Health Services at Aliceville)
- Whatley Health Services, Inc. (Aliceville Student Health and Wellness Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.