Active NPI
Russell Franklin Pruitt, M.D.
- Surgery Physician
- Acworth, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 041931
- Practice address
- 4900 Ivey Rd NW BLDG 1000
Suite 1025
Acworth, GA 30101-4001 - Phone
- (770) 917-9557
- Fax
- (770) 917-9558
- NPI assigned
- Oct 18, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 041931 | GA | |
| Surgery Physician | 208600000X | 041931 | GA | Primary |
Addresses
Primary practice location
4900 Ivey Rd NW BLDG 1000
Suite 1025
Acworth, GA 30101-4001
Mailing address
4900 Ivey Rd NW BLDG 1000
Suite 1025
Acworth, GA 30101-4001
Phone (770) 917-9557
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050105000490 | GA | Practitioner - General Surgery | 2860440930 | Reassigns benefits to 8 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Emory University School of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Piedmont Athens Hospitalist Physicians LLCElbert Memorial Hospital
Practice addresses (Care Compare)
1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-5076
33 Chestnut St
Elberton, GA 30635-1833
Phone (706) 213-2580
Hospital & facility affiliations
- Piedmont Athens Regional Medical Center
- Elbert Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 21 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 15 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041931 | GA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephens County Hospital Physician Group, LLC | Current | Accepting new patients | |
| Stephens County Hospital Authority | Current | Accepting new patients | |
| Stephens County Hospital Physician Group, LLC | Current | Accepting new patients | |
| Tift Regional Health System Inc | Surgery | Current | Accepting new patients |
| Elbert Memorial Hospital | Surgery | Current | Accepting new patients |
| Northside Surgical Professional Services LLC | Surgery | Current | Accepting new patients |
| Piedmont Providers LLC | Current | Accepting new patients | |
| Piedmont Athens Hospitalist Physicians LLC | Current | Accepting new patients | |
| Stephens County Hospital Physician Group LLC | Surgery | Current | Accepting new patients |
| Elbert Memorial Hospital | Current | Accepting new patients | |
| Stephens County Hospital Authority | Current | Accepting new patients | |
| Tift Regional Health System Inc | Current | Accepting new patients | |
| Stephens County Pathology Associates LLC | Current | Accepting new patients | |
| Piedmont Healthcare Inc | Current | Accepting new patients | |
| Tift Regional Health System Inc | Current | Accepting new patients | |
| Papp Clinic Laboratory | Past | Accepting new patients | |
| Cartersville Surgical Associates, P.C. | Specialist | Past | Accepting new patients |
| DHP of Maryland PC | Surgery | Past | Accepting new patients |
| Piedmont Athens Regional Medical Center, Inc. | Past | Accepting new patients | |
| Elbert Memorial Hospital | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Piedmont Athens Specialty Care LLC | Surgery | Past | Accepting new patients |
| Delphi Healthcare Specialists of Georgia, LLC | Surgery | Past | Accepting new patients |
Locations
1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520
2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421
1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210
1984 Peachtree Rd NW
Ste 205
Atlanta, GA 30309
450 Northside Cherokee Blvd
Ste 300
Canton, GA 30115
33 Chestnut St
Elberton, GA 30635
Phone (706) 213-2580
380 Hospital Dr
Ste 320
Macon, GA 31217
Phone (478) 742-5331
350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367
400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000
15 Cavender St
Newnan, GA 30263
Phone (770) 253-6616
1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737
1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000
1700 Tree Ln
Ste 450
Snellville, GA 30078
Phone (770) 979-9005
901 18th St E
Tifton, GA 31794
Phone (229) 353-6208
2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188
163 Hospital Dr
Toccoa, GA 30577
Phone (706) 282-4200
115 Rock Quarry Rd
Toccoa, GA 30577
Phone (706) 282-5815
Interoperability endpoints
- russell.pruitt.1@14936.direct.athenahealth.com
- russell.pruitt.1@13373.direct.athenahealth.com
Organizations & group practices 24
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1578079000
GA
-
- Surgery Physician
- Atlanta, GA
- NPI 1356630990
GA, Surgery
-
- Internal Medicine Physician
- Toccoa, GA
- NPI 1659761955
GA, Surgery
-
- Rural Health Clinic/Center
- Hartwell, GA
- NPI 1770322117
-
- Critical Access Hospital
- Elberton, GA
- NPI 1669488250
-
- Ambulance
- Elberton, GA
- NPI 1134839343
-
- Community/Retail Pharmacy
- Toccoa, GA
- NPI 1760251367
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Athens, GA
- NPI 1437186111
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459296000000",
"number": "1992886667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4900 IVEY RD NW BLDG 1000",
"address_2": "SUITE 1025",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301014001",
"telephone_number": "770-917-9557",
"fax_number": "770-917-9558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 IVEY RD NW BLDG 1000",
"address_2": "SUITE 1025",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301014001",
"telephone_number": "770-917-9557",
"fax_number": "770-917-9558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUITT",
"first_name": "RUSSELL",
"middle_name": "FRANKLIN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2016-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "041931",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "041931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Acworth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.