Adam J Pruett, M.D.
Individual provider Active NPI Psychiatry Physician · Manchester, VT
NPI 1609050756 · NPPES record last updated Jun 6, 2023
Key facts
- NPI
- 1609050756
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 042.0013999 (VT)
- Practice address
- 4384 Main Street
Manchester, VT 05254-8945 - Phone
- (802) 768-9136
- Fax
- (802) 662-2173
- NPI assigned
- Dec 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 13
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in AL, SD, VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100723000187 | AL | Practitioner - Psychiatry | 7315079563 | Reassigns benefits to 2 organizations |
| I20170905001047 | SD | Practitioner - Psychiatry | 7315079563 | Reassigns benefits to 1 organization |
| I20180813002462 | VT | Practitioner - Psychiatry |
7315079563 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28584 | AL | MD | Psychiatry Physician |
| 059863 | GA | MD | Psychiatry Physician |
| 042.0013999 | VT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Health Care Authority of the City of Anniston | Current |
Accepting new patients | |
| Regional Medical Center Board | Current |
Accepting new patients | |
| Regional Health Management Corporation | Current |
Accepting new patients | |
| The Health Care Authority of the City of Anniston | Current | Accepting new patients | |
| Brattleboro Retreat | Current |
Accepting new patients | |
| Anniston Pathology | Current | Accepting new patients | |
| Springfield Medical Care Systems Inc | Current |
Accepting new patients | |
| Regional Health Management Corporation | Psychiatry | Current |
Accepting new patients |
| Monument Health Rapid City Hospital, Inc. | Current |
Accepting new patients | |
| Springfield Medical Care Systems Inc. | Current |
Accepting new patients | |
| Taconic Integrative Psychiatric Services, PLLC | Psychiatry | Current |
Accepting new patients |
| Rutland Hospital, Inc | Past |
Accepting new patients |
Locations
400 E 10th St
Anniston, AL 36207
Phone (256) 235-5121
901 Leighton Ave
Ste 204
Anniston, AL 36207
Phone (256) 235-5015
353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000
1 Hospital Ct
Bellows Falls, VT 05101
Phone (802) 463-1292
22 Anna Marsh Ln
Dummerston, VT 05301
Phone (802) 258-3700
25 Ridgewood Rd
Springfield, VT 05156
Phone (780) 281-9593
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/6f43d0e7-6ff2-489b-abdc-44e8a5e0ca0a/
- https://api.platform.athenahealth.com/15682/brand/1/csg/1/fhir/r4
- https://api.platform.athenahealth.com/21546/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 059863 | GA | |
| Psychiatry Physician | 2084P0800X | 28584 | AL | |
| Psychiatry Physician | 2084P0800X | 042.0013999 | VT | Yes |
Addresses
Primary practice location
4384 Main Street
Manchester, VT 05254-8945
Mailing address
PO Box 255
Manchester, VT 05254-0255
Phone (802) 768-9136
Other providers in Manchester, VT
- Metta Healing, LLC
- Marion Miller-Rumney
- Tamra F Mooney
- Pinkus Family Chiropractic
- Kathleen Pinkus
- Philip Hostage Russell
- Taconic Integrative Psychiatric Services, PLLC
- Patricia Ann Toth
- Kathleen Anne Townsend
- Heidie Vazquez-Garcia
All providers in Manchester, VT · Psychiatry Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.