Madeline Pruitt

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1488 Brook Valley LN NE
Atlanta, GA 30324-3264

Phone

(812) 629-6321

NPI assigned

Oct 20, 2022

Last updated

Oct 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 GA

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

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Physician Services - Southeast Professional CorporationGroup PAC ID 5597774554, 825 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385
  Medicare reassignment Care Compare group
• Inphynet Primary Care Physicians Southeast PC

  • Emergency Medicine Physician
  • Columbus, GA
  • NPI 1770521460
  Medicare reassignment

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

• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  Care Compare affiliation

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1245957224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 BROOK VALLEY LN NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303243264",
            "telephone_number": "812-629-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 BROOK VALLEY LN NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303243264",
            "telephone_number": "812-629-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "MADELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Lewis Humphrey Pruett
• Megan Consedine Pruett, CPNP
• Antonio VA'Shawn Pruitt, PT,DPT,MPA
• Jimmy Daniel Pruitt, MD
• Kelley Pruitt
• Roseann Pruitt, PA-C, ATC
• Terri Melvin Pruitt, MD
• Tiffany Lynnette Pruitt
• Pruitthealth - Brookhaven, LLC (PruittHealth - Brookhaven)
• Pruitthealth - Virginia Park, LLC (PruittHealth - Virginia Park)

• Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.