Adam Pruett, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164.007263 Issued in IL

Practice address

5900 Bond Ave
East Saint Louis, IL 62207-2326

Phone

(618) 332-5458

NPI assigned

Apr 4, 2018

Last updated

Apr 4, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1386140614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5116 EAGLE WING CT",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630254043",
            "telephone_number": "636-584-9153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BOND AVE",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622072326",
            "telephone_number": "618-332-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "ADAM",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2008029468",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.007263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rina S. Patney, M.D.
• Marianna Peterson, MSW
• Sandra Marie Pettiford, P. T.
• Tina Yvonne Pettiford, LPC
• Verna J. Porter, MD
• Kayla Ann Pryor, APRN
• Leah Pulley
• Pure Living Recovery and Rehabilition Center
• Quality Home Care Solutions Inc
• Jewel Radford, RN

• Registered Dietitian in East Saint Louis, IL
• Providers in East Saint Louis, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; 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.