Active NPI
Kayla Pruitt
- Behavior Technician
- Spring Lake, NC
National Provider Identifier
1669938239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-19-78877
- Practice address
- 1018 N Bragg Blvd
Spring Lake, NC 28390-3316 - Phone
- (910) 295-2609
- NPI assigned
- Feb 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-19-78877 | NC | Primary |
Addresses
Primary practice location
1018 N Bragg Blvd
Spring Lake, NC 28390-3316
Mailing address
52 Pinecrest Dr Apt C
Spring Lake, NC 28390-7342
Phone (919) 478-3269
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-19-78877 | NC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579824000000",
"number": "1669938239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 PINECREST DR APT C",
"city": "SPRING LAKE",
"state": "NC",
"postal_code": "283907342",
"telephone_number": "919-478-3269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1018 N BRAGG BLVD",
"city": "SPRING LAKE",
"state": "NC",
"postal_code": "283903316",
"telephone_number": "910-295-2609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUITT",
"first_name": "KAYLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-19",
"last_updated": "2020-01-24",
"certification_date": "2020-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NC",
"license": "RBT-19-78877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Lake, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.