Individual provider Active NPI

John W Pruett, M.D.

  • Psychiatry Physician
  • Reno, NV
National Provider Identifier
1881623106
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1299-320 Issued in WI
Practice address
1240 E 9TH St
Reno, NV 89512-2964
Phone
(775) 323-0478
Fax
(775) 789-4437
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 16290 NV
Psychiatry Physician 2084P0800X 15727 MS
Child & Adolescent Psychiatry Physician 2084P0804X 16290 NV
Child & Adolescent Psychiatry Physician 2084P0804X 15727 MS
Psychiatry Physician 2084P0800X 1299-320 WI Primary

Addresses

Primary practice location

1240 E 9TH St
Reno, NV 89512-2964

Mailing address

PO Box 22040
Green Bay, WI 54305-2040
Phone (920) 445-7222

Other practice location 1

301 E Saint Joseph St
Green Bay, WI 54301-2241
Phone (920) 433-6073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, AL, MN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210707003682 WI Practitioner - Psychiatry 1153558465 Reassigns benefits to 1 organization
I20250915002929 AL Practitioner - PsychiatryPractitioner - Other (Physician) 1153558465 Reassigns benefits to 1 organization
I20251203002348 MN Practitioner - Psychiatry 1153558465

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of South Alabama College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Behavioral Health IncGroup PAC ID 7416194113, 109 clinicians

Practice addresses (Care Compare)

1615 Kathy LN SW
Decatur, AL 35603-1026
Phone (256) 288-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15727MSMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic LTD CurrentSince Dec 22, 2025 Accepting new patients
Bellin Psychiatric Center Inc. CurrentSince Jun 28, 2021 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Dec 22, 2025 Accepting new patients
Integrated Behavioral Health, Inc. Psychiatry CurrentSince Jun 28, 2025 Accepting new patients
Bellin Psychiatric Center Inc Psychiatry CurrentSince Jun 28, 2021 Accepting new patients
SMDC Medical Center Past Accepting new patients
H H Health System-Morgan LLC Past Accepting new patients

Locations

1615 Kathy Ln SW
Decatur, AL 35603
Phone (256) 306-4000

600 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

25850 Main St
Ardmore, TN 38449
Phone (931) 427-4050

301 Saint Joseph St
Green Bay, WI 54301
Phone (920) 430-3630

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1881623106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22040",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052040",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 E 9TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895122964",
            "telephone_number": "775-323-0478",
            "fax_number": "775-789-4437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Saint Joseph St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543012241",
            "country_code": "US",
            "telephone_number": "920-433-6073",
            "fax_number": "920-431-0333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "16290",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "15727",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NV",
            "license": "16290",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MS",
            "license": "15727",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "1299-320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.