Individual provider Active NPI

Mayme Deshea Pruitt, RPH

  • Pharmacist
  • Paducah, KY
National Provider Identifier
1356944565
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
011283 Issued in KY
Practice address
3275 Irvin Cobb Dr
Paducah, KY 42003-0338
Phone
(270) 443-4885
NPI assigned
Nov 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 011283 KY Primary

Addresses

Primary practice location

3275 Irvin Cobb Dr
Paducah, KY 42003-0338

Mailing address

345 Peppers Mill Dr
Paducah, KY 42001-8903
Phone (270) 350-5585

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL sheapruitt

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 Pharmacist

State licenses

LicenseStateTypeSpecialty
011283KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky CVS Pharmacy, L.L.C. PastSince Nov 22, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1356944565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 PEPPERS MILL DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420018903",
            "telephone_number": "270-350-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3275 IRVIN COBB DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420030338",
            "telephone_number": "270-443-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "MAYME",
        "middle_name": "DESHEA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "011283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "sheapruitt",
            "affiliation": "N",
            "address_1": "3275 Irvin Cobb Dr",
            "city": "Paducah",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420030338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.