Courtney Pruitt

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

115301 Issued in TX

Practice address

1602 Diana Dr
Round Rock, TX 78664-5732

Phone

(325) 451-4019

NPI assigned

May 21, 2020

Last updated

May 21, 2020By the provider in NPPES

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)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Functional Pathways of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1922218122
  NPD (past)

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1518580737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 DIANA DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786645732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 DIANA DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786645732",
            "telephone_number": "325-451-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-21",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "115301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Ann Proctor, LPC
• Professional Massage Associates PLLC
• Profound Hospice Care, LLC
• Progressive Life, LTD (Progressive Life of Central Texas)
• Donna Marie Prokop-Fettig, P.A.-C
• Alexis Claris Pruneda, LPC-A
• Madison Ashley Pryor, PA-C
• Psychological Solutions, PLLC
• Madison Ptacek
• Stephanie Marie Puente, MS, LPC-A

• Speech-Language Pathologist in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.