NPIMap

Individual provider Active NPI

Roseann Pruitt, PA-C, ATC

  • Medical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1114304284
Registry record updated Mar 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9174 Issued in GA
Practice address
1762 Clifton Rd NE
Ste 1650
Atlanta, GA 30322-4001
Phone
(978) 618-7329
NPI assigned
Apr 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT001944 GA
Physician Assistant 363A00000X GA
Medical Physician Assistant 363AM0700X 9174 GA Primary

Addresses

Primary practice location

1762 Clifton Rd NE
Ste 1650
Atlanta, GA 30322-4001

Mailing address

169 Redtail Rd
Jefferson, GA 30549-7070
Phone (978) 618-7329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190424001284 GA Practitioner - Physician Assistant 3375885247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711

Hospital & facility affiliations

  • Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078
  • Emory University Hospital Hospital, Atlanta, GA, CCN 110010
  • Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076
  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082
  • Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
AT001944GAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Jul 30, 2020 Accepting new patients
The Emory Clinic Inc CurrentSince Apr 1, 2019 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jul 30, 2020 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: rpruitt21377@direct.emory.org

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552176000000",
    "number": "1114304284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 REDTAIL RD",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305497070",
            "telephone_number": "978-618-7329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 CLIFTON RD NE",
            "address_2": "STE 1650",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303224001",
            "telephone_number": "978-618-7329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "ROSEANN",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2019-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT001944",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "9174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.