Tiffany Lynnette Pruitt

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN219329 Issued in GA

Practice address

250 Georgia Ave SE Ste 206
Atlanta, GA 30312-3000

Phone

(404) 653-0374

NPI assigned

Apr 26, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1861980666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4032 PINE MANOR DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 GEORGIA AVE SE STE 206",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123000",
            "telephone_number": "404-653-0374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "TIFFANY",
        "middle_name": "LYNNETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN219329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jimmy Daniel Pruitt, MD
• Kelley Pruitt
• Madeline Pruitt
• Roseann Pruitt, PA-C, ATC
• Terri Melvin Pruitt, MD
• Pruitthealth - Brookhaven, LLC
• Pruitthealth - Virginia Park, LLC
• Pruitthealth - West Atlanta, LLC
• Pruittplace - Buckhead, LLC
• Pruittplace - Sandy Springs, LLC

• Registered Nurse in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.