Kelli Elizabeth Pruitt

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R883741 Issued in MS

Practice address

2969 Curran Dr N
Jackson, MS 39216-4121

Phone

(601) 540-5598

NPI assigned

Jun 27, 2014

Last updated

May 31, 2023By 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 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maxem Health Urgent Care MageeGroup PAC ID 9537419643, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpruitt3070254@direct.casso.us.com

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.

• Maxem Health Urgent Care Magee

  dba Magee Urgent Care

  • Urgent Care Clinic/Center
  • Magee, MS
  • NPI 1235669136
  Medicare reassignment Care Compare group NPD
• Maxem Health Urgent Care Diberville

  • Urgent Care Clinic/Center
  • D'Iberville, MS
  • NPI 1265991608
  Medicare reassignment NPD
• Maxem Health Urgent Care McComb

  dba McComb Urgent Care

  • Urgent Care Clinic/Center
  • McComb, MS
  • NPI 1235619479
  Medicare reassignment NPD
• Ocean Springs Urgent Care

  • Urgent Care Clinic/Center
  • Ocean Springs, MS
  • NPI 1871808022
  Medicare reassignment NPD
• Orange Grove Urgent Care

  • Urgent Care Clinic/Center
  • Gulfport, MS
  • NPI 1831330661
  Medicare reassignment NPD
• Pascagoula Urgent Care

  • Urgent Care Clinic/Center
  • Pascagoula, MS
  • NPI 1235442872
  Medicare reassignment NPD
• Picayune Urgent Care Clinic, LLC

  • Urgent Care Clinic/Center
  • Picayune, MS
  • NPI 1780723502
  Medicare reassignment NPD
• Maxem Health Urgent Care Flowood

  dba Flowood Urgent Care

  • Urgent Care Clinic/Center
  • Flowood, MS
  • NPI 1174070650
  Medicare reassignment
• Gulfport 49 Imaging, LLC

  • Radiology Clinic/Center
  • Gulfport, MS
  • NPI 1134702301
  NPD
• Aderis Health Technologies

  dba Aderis Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Orlando, FL
  • NPI 1124751821

  Family

  NPD (past)
• Med RX Partners, P.C.

  dba Med Rx Partners

  • Psychiatric/Mental Health Nurse Practitioner
  • Vancouver, WA
  • NPI 1114586070
  NPD (past)
• Med RX Partners, PC

  dba Med Rx Partners

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1528881299
  NPD (past)

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1285049254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2969 CURRAN DR N",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164121",
            "telephone_number": "601-540-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2969 CURRAN DR N",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164121",
            "telephone_number": "601-540-5598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5512 NE 109th Ct Ste I",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986626175",
            "country_code": "US",
            "telephone_number": "360-200-5273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1529 Simpson Highway 49",
            "address_purpose": "LOCATION",
            "city": "Magee",
            "state": "MS",
            "postal_code": "391114209",
            "country_code": "US",
            "telephone_number": "601-439-7288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "KELLI",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11007306",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R883741",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11007306",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R883741",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61401686",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10006919",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07407051",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Nicholas Protos, M.D.
• Providence Hospice, LLC
• Thomas Prude, PCMHT
• Ellyn Burton Pruett, FNP-C
• Eleanor Karen Pruitt, DMD
• Shapard H Pryor Jr., MD
• Tyranny Pryor
• Rick A Psonak, CPO
• John Austin Puckett, MD
• Zachary Neal Puckett, CPNP-AC/PC

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.