Shanika Shanta Pruitt, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2017000938 Issued in MO

Practice address

1400 Lemay Ferry Rd
Saint Louis, MO 63125

Phone

(314) 827-6868

Fax

(314) 627-4546

NPI assigned

Jan 25, 2017

Last updated

Dec 8, 2021By 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

Enrolled in MO

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 1

Medicare enrollment (NPD)

Enrolled

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

• Interfaith Residence

  dba Key Clinic

  • Infectious Disease Physician
  • Saint Louis, MO
  • NPI 1164235362
  Medicare reassignment NPD
• Vpa PC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1760706337
  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  MO

  Medicare reassignment NPD
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  MO

  Medicare reassignment
• Hearts Connecting Health Consultants

  • Clinical Medical Laboratory
  • Saint Louis, MO
  • NPI 1811568470
  Authorized official Same address or phone
• Vpa PC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1659818904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 SAINT LOUIS AVE UNIT 11169",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631352783",
            "telephone_number": "314-827-6868",
            "fax_number": "314-627-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 LEMAY FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63125",
            "telephone_number": "314-827-6868",
            "fax_number": "314-627-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "SHANIKA",
        "middle_name": "SHANTA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017000938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher S Pruett, M.D.
• John Robert Pruett, MD
• Joseph Pruett, RPH
• Cassandra Michelle Pruitt, MD
• Donald L. Pruitt, MD
• Trenton Pruitt
• Ashley Prulliere, PT
• Megan Prunty, MD
• Joseph Prusaczyk, MD
• Nataliya Pruss

• Family Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.