Active NPI
Tiffany Pruitt, R.N.
- Registered Nurse
- Garden City, KS
National Provider Identifier
1306054341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 13-91395-121
- Practice address
- 712B Saint John St
Garden City, KS 67846-5128 - Phone
- (620) 275-1766
- Fax
- (275) 275-4729
- NPI assigned
- May 21, 2007
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 13-91395-121 | KS | Primary |
Addresses
Primary practice location
712B Saint John St
Garden City, KS 67846-5128
Mailing address
712B Saint John St
Garden City, KS 67846-5128
Phone (620) 275-1766
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13-91395-121 | Other | KS | KANSAS STATE BOARD OF NUR |
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13-91395-121 | KS | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306054341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712B SAINT JOHN ST",
"city": "GARDEN CITY",
"state": "KS",
"postal_code": "678465128",
"telephone_number": "620-275-1766",
"fax_number": "275-275-4729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712B SAINT JOHN ST",
"city": "GARDEN CITY",
"state": "KS",
"postal_code": "678465128",
"telephone_number": "620-275-1766",
"fax_number": "275-275-4729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUITT",
"first_name": "TIFFANY",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "KS",
"license": "13-91395-121",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KANSAS STATE BOARD OF NUR",
"identifier": "13-91395-121",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garden City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.