Gina Dombalis Pruitt, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5526 Issued in NC

Practice address

210 Charlois Blvd
Winston Salem, NC 27103-1508

Phone

(336) 725-0222

Fax

(336) 725-0454

NPI assigned

Dec 15, 2022

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Speechcenter LLC, D/B/a Sidekick Therapy Partners

  • Speech-Language Pathologist
  • Winston Salem, NC
  • NPI 1306840251
  NPD (past)

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1447962014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 BEAVERTON TRL",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035270",
            "telephone_number": "336-575-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031508",
            "telephone_number": "336-725-0222",
            "fax_number": "336-725-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "GINA",
        "middle_name": "DOMBALIS",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "5526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Michael Provenza, MD
• Provision Home Care Agency, LLC
• Brittany Marie Proxmire, MA, LCMHC-A
• Jaron Kai Pruett, MD
• Jean F Pruett, LPC
• Kelly Sheppard Pruitt, LCMHC
• Zachary David Pruitt, MD
• Pruittplace - Winston Salem LLC
• Prybylo Ess Physical Therapy Inc
• Sharon Ambuske Prybylo, DPT

• Speech-Language Pathologist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.