Jesse Nathaniel Pruitt, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD15030 Issued in AR

Practice address

904 Autumn Rd Ste 275
Little Rock, AR 72211-3745

Phone

(501) 224-3499

Fax

(501) 224-3499

NPI assigned

Apr 18, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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.

• Dalton Herzig, Inc.

  • Community/Retail Pharmacy
  • Little Rock, AR
  • NPI 1750934287
  NPD
• Park West Pharmacy

  • Pharmacy
  • Little Rock, AR
  • NPI 1053308940
  NPD (past)

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688428800000",
    "number": "1497498372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 AUTUMN RD STE 275",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113745",
            "telephone_number": "501-224-3499",
            "fax_number": "501-224-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 AUTUMN RD STE 275",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113745",
            "telephone_number": "501-224-3499",
            "fax_number": "501-224-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "JESSE",
        "middle_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-18",
        "last_updated": "2023-07-04",
        "certification_date": "2023-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD15030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR PHARMACIST LICENSE",
            "identifier": "PD15030",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Patrick Proveaux, LCSW
• Craig Joseph Provost, PH.D.
• Dale Cordes Provost, PH.D.
• Sharon Prowell, LMSW
• Benjamin Parker Pruitt, MD CLASS OF 2025
• Kassie Danielle Pruitt, MHPP
• Michael Pruitt
• Samantha Pruitt, DPT
• Sandra Emily Pruitt, MD
• Tad C Pruitt, M.D.

• Pharmacist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2023; 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.