Active NPI
Emily Diane Pruitt
- Family Nurse Practitioner
- Winnsboro, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP10208
- Practice address
- 2106 Loop Rd
Winnsboro, LA 71295-3344 - Phone
- (318) 435-9411
- Fax
- (318) 435-9260
- NPI assigned
- Jul 6, 2018
- Last updated
- Sep 21, 2018
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP10208 | LA | Primary |
Addresses
Primary practice location
2106 Loop Rd
Winnsboro, LA 71295-3344
Mailing address
2106 Loop Rd
Winnsboro, LA 71295-3344
Phone (318) 435-9411
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F07181660 | Other | CERTIFICATION | |
| 14296793 | Other | CAQH | |
| 2478486 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
57 Pinecrest Dr
Pineville, LA 71360-4284
Phone (318) 232-6071
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP10208 | LA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lsu Health Sciences Center Shreveport Faculty Group Practice | Current | Accepting new patients | |
| Calcasieu Urgent Care, LLC | Current | Accepting new patients | |
| Upperline Healthcare, PC | Current | Accepting new patients | |
| Calcasieu Urgent Care LLC | Current | Accepting new patients | |
| Upperline Healthcare, PC | Current | Accepting new patients | |
| Franklin Parish Hospital Service Dist 1 | Current | Accepting new patients | |
| Franklin Parish Hospital Service Dist 1 | Current | Accepting new patients |
Locations
2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919
1121 Polk St
Mansfield, LA 71052
Phone (318) 575-2143
4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000
57 Pinecrest Dr
Pineville, LA 71360
Phone (318) 232-6071
1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287
1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402
132 Well Rd
West Monroe, LA 71291
Phone (318) 217-6521
2104 Loop Rd
Ste C
Winnsboro, LA 71295
Phone (318) 435-4571
2106 Loop Rd
Winnsboro, LA 71295
Phone (318) 282-8482
5745 Highway 17
Winnsboro, LA 71295
Phone (318) 722-3333
Interoperability endpoints
- diane.pruitt.1@13199.direct.athenahealth.com
Organizations & group practices 7
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.
-
dba Calcasieu Urgent Care
- Urgent Care Clinic/Center
- Lake Charles, LA
- NPI 1467715490
-
dba Franklin Medical Center
- Rural Acute Care Hospital
- Winnsboro, LA
- NPI 1619143120
-
- Family Medicine Physician
- Shreveport, LA
- NPI 1013374222
-
- Rural Health Clinic/Center
- Breaux Bridge, LA
- NPI 1194482398
-
dba Gilbert Health Center
- Rural Health Clinic/Center
- Gilbert, LA
- NPI 1669002002
-
- Foot & Ankle Surgery Podiatrist
- Ocoee, FL
- NPI 1326906843
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537488000000",
"number": "1760978449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2106 LOOP RD",
"city": "WINNSBORO",
"state": "LA",
"postal_code": "712953344",
"telephone_number": "318-435-9411",
"fax_number": "318-435-9260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2106 LOOP RD",
"city": "WINNSBORO",
"state": "LA",
"postal_code": "712953344",
"telephone_number": "318-435-9411",
"fax_number": "318-435-9260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUITT",
"first_name": "EMILY",
"middle_name": "DIANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-06",
"last_updated": "2018-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "AP10208",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFICATION",
"identifier": "F07181660",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "14296793",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2478486",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winnsboro, LA
- Courtney Kemper Pickett, CCC-SLP
- Plantation Manor Nursing & Rehabilitation Center, LLC (Plantation Manor Nursing & Rehabilitation Center)
- Chad Thomas Porter, M.D.
- Powell Medical Transportation, LLC
- Pauline T Powell
- Charles E Reed, M.D.
- Rehabilitation Services of Louisiana, LLC
- Rinata Kaye Richard, MD
- Jon L Richardson, PT
- Edwina Elrod Rieger, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.