Katie Martin Pruitt, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024186013 Issued in VA

Practice address

1970 Roanoke Blvd
Salem, VA 24153-6404

Phone

(540) 982-2463

NPI assigned

Jan 6, 2023

Last updated

Jan 6, 2023By the provider in NPPES

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

Other names 1

• Katie Irene Martin Former name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Center for Care and Resiliency, PLLCGroup PAC ID 5395135420, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Care and Resiliency, PLLC

  • Mental Health Counselor
  • Roanoke, VA
  • NPI 1053902742
  Medicare reassignment Care Compare group NPD
• JLC Services Inc.

  • Psychiatry Physician
  • Broadview Heights, OH
  • NPI 1417739699

  VA

  Medicare reassignment NPD
• Arman C. Moshyedi, MD, PLLC

  • Psychiatry Physician
  • McLean, VA
  • NPI 1366005183
  NPD (past)
• Greenbrook TMS Roanoke

  • Psychiatry Physician
  • Roanoke, VA
  • NPI 1427561059
  NPD (past)
• Wythe County Physician Practices LLC

  • Family Medicine Physician
  • Wytheville, VA
  • NPI 1780630327
  NPD (past)

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1215641071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2965 Colonnade Dr Ste 307",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240183561",
            "country_code": "US",
            "telephone_number": "540-344-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "KATIE",
        "middle_name": "MARTIN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024186013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "MARTIN",
            "middle_name": "IRENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John W Priddy, M.D.
• Primary Care Associates PC
• Denver Louis Pritchard Jr., LCSW
• Benedict A Profera, DPM, MPH
• Richard Prokopchak, MD
• Pulaski VA Clinic
• Vennela Pulikanti, DO
• Shermir Pulliam
• Quarles Care PLLC
• Tayliah Quiles-Sisk

• Psychiatric/Mental Health Nurse Practitioner in Salem, VA
• Providers in Salem, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.