Active NPI
James William Pruett, PH.D; D.MIN.
- Pastoral Counselor
- Charlotte, NC
National Provider Identifier
1801872445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- 41
- Practice address
- 3900-B Park Rd
Charlotte, NC 28209 - Phone
- (704) 577-5862
- Fax
- (864) 574-8142
- NPI assigned
- Dec 15, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 41 | NC | Primary |
Addresses
Primary practice location
3900-B Park Rd
Charlotte, NC 28209
Mailing address
664 W Heatherstone LN
Roebuck, SC 29376-2787
Phone (704) 577-5862
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgepath Inc | Pastoral | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487116800000",
"number": "1801872445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "664 W HEATHERSTONE LN",
"city": "ROEBUCK",
"state": "SC",
"postal_code": "293762787",
"telephone_number": "704-577-5862",
"fax_number": "864-574-8142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900-B PARK RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28209",
"telephone_number": "704-577-5862",
"fax_number": "864-574-8142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUETT",
"first_name": "JAMES",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "PH.D; D.MIN.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-15",
"last_updated": "2017-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "NC",
"license": "41",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.