Anna Davenport Shealy Pruitt, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12215 Issued in NC

Practice address

5821 Fairview Rd Ste 106
Charlotte, NC 28209-3649

Phone

(704) 826-3550

Fax

(704) 538-4135

NPI assigned

Jan 31, 2021

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

Other names 1

• Anna Davenport Shealy Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Avance Care, PA

  • Clinic/Center
  • Fuquay Varina, NC
  • NPI 1487845020
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1612051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1821689068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 UNIVERSITY DR BLDG 700",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073489",
            "telephone_number": "484-900-1317",
            "fax_number": "866-538-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 FAIRVIEW RD STE 106",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093649",
            "telephone_number": "704-826-3550",
            "fax_number": "704-538-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "ANNA",
        "middle_name": "DAVENPORT SHEALY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-31",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "SHEALY",
            "middle_name": "DAVENPORT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Provital Transit, LLC
• Provizions Care LLC
• Benjamin Thomas Pruden, M.D.
• Lindsay McCarthy Pruden, PA
• James William Pruett, PH.D; D.MIN.
• Brandy N Pruitt
• Jimmy L Pruitt III, PHARMD
• Julie A. Pruitt, PH.D.
• Marta Pruitt, FNP
• Pruitthealth Home Health, Inc.

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.