Sandra L Pruett, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

GAA-NP000964 Issued in GA

Practice address

55 Whitcher St NE Ste 160
Marietta, GA 30060-1160

Phone

(770) 590-4180

Fax

(770) 590-4186

NPI assigned

May 7, 2009

Last updated

Nov 14, 2022By 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 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DE, MD, GA3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayhealth Medical Center, Kent Campus Hospital, Dover, DE, CCN 080004

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spruett498496@directwellstar.org

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.

• Creative Medical Consulting, LLC

  • Family Nurse Practitioner
  • Middletown, DE
  • NPI 1578051819
  Medicare reassignment NPD
• Union Hospital of Cecil County

  • Internal Medicine Physician
  • Elkton, MD
  • NPI 1124067848
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  NPD
• Union Hospital of Cecil County

  dba Union Behavioral Health

  • Psychiatry Physician
  • Elkton, MD
  • NPI 1689978751
  NPD
• Cardiology Physicians, LLC

  dba Cvpde

  • Cardiovascular Disease Physician
  • Newark, DE
  • NPI 1952338212
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bayhealth Medical Center, Inc.

  dba Bayhealth Hospital, Kent Campus

  • General Acute Care Hospital
  • Dover, DE
  • NPI 1467546135
  Care Compare affiliation

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1750515649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE STE 160",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601160",
            "telephone_number": "770-590-4180",
            "fax_number": "770-590-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE STE 160",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601160",
            "telephone_number": "770-590-4180",
            "fax_number": "770-590-4186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4755 Ogletown Stanton Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197186289",
            "country_code": "US",
            "telephone_number": "302-733-4797",
            "fax_number": "302-733-4877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "SANDRA",
        "middle_name": "L",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0017162",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "DE",
            "license": "LB-0000225",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "AC001270",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "GAA-NP000964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spruett498496@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "55 Whitcher St NE Ste 160",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allex Provens, MA
• Providence Dental Spa of East Cobb, LLC (Providence Dental Spa of East Cobb)
• Providence Rd Primary Care LLC
• Kaynessa Celena Providence, M.D.
• Provident Healthcare LLC
• Lashanti Melba Pruitt, MA
• Pruitthealth - Marietta, LLC (PruittHealth - Marietta)
• Pruittplace - East Cobb, LLC
• Mariah Christine Pryor, AAC
• PS DDS

• Adult Health Nurse Practitioner in Marietta, GA
• Providers in Marietta, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.