Tatesha M Pruitt, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA05638 Issued in TX

Practice address

1655 NE Loop 286
Paris, TX 75460-2219

Phone

(903) 739-9191

NPI assigned

Jun 18, 2008

Sex

Female

Sole proprietor

Yes

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

Enrolled in TX, CA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Apex Emergency Medical Group, Inc.

  • Emergency Medicine Physician
  • Hemet, CA
  • NPI 1265711089
  Medicare reassignment
• Choctaw Nation of Oklahoma

  • Rural Acute Care Hospital
  • Talihina, OK
  • NPI 1659347623

  TX

  Medicare reassignment
• Choctaw Nation of Oklahoma

  • Primary Care Clinic/Center
  • Idabel, OK
  • NPI 1407822497
  NPD
• Choctaw Nation of Oklahoma

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Broken Bow, OK
  • NPI 1447143532
  NPD
• Four States Emergency Physicians

  • Emergency Medicine Physician
  • Texarkana, TX
  • NPI 1922051440
  NPD (past)
• Red River Valley Radiology Associates

  • Diagnostic Radiology Physician
  • Paris, TX
  • NPI 1841216918
  NPD (past)
• Salas Urgent Care LLC

  • Urgent Care Clinic/Center
  • Paris, TX
  • NPI 1245189471
  NPD (past)
• Texas Em-1 Medical Services, PA

  • Nurse Practitioner
  • Sulphur Springs, TX
  • NPI 1477741486
  NPD (past)
• Texas Em-1 Medical Services, PA

  • Physician Assistant
  • Texarkana, TX
  • NPI 1558314062
  NPD (past)

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1487815809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 NE LOOP 286",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754602219",
            "telephone_number": "903-739-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 NE LOOP 286",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754602219",
            "telephone_number": "903-739-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "TATESHA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PRMC Health Group Inc
• PRMC Healthcare Group Inc
• Pro Lab Pharmacy
• Kendra Deann Proctor, RN, CFNP
• Prolab
• PTX Psychiatry PLLC
• Pulsepoint Urgent Care Inc
• Russell Walker Putnam, M.D.
• Pyramid Healthcare Corp
• Quality Care ER, LLC

• Physician Assistant in Paris, TX
• Providers in Paris, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.