ROSEANN PRUITT (NPI# 1114304284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114304284 |
| Entity Type | Individual |
| Full Name | ROSEANN PRUITT |
| Credential | PA-C, ATC |
| Practice Address |
1762 Clifton Rd Ne Ste 1650 Atlanta GA 30322-4001 |
| Mailing Address |
169 Redtail Rd Jefferson GA 30549-7070 |
| Practice Telephone | 9786187329 |
| Mailing Telephone | 9786187329 |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2019-03-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT001944 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 363A00000X | Physician Assistant | GA | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
9174 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1762 CLIFTON RD NE STE 1650 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30322-4001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033167739 | Emory University, School of Medicine | General Acute Care Hospital | 1762 Clifton Rd Ne, Atlanta, GA 30322-4001 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445830 | Justin Gill | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Clinic B - Suite B6100, Atlanta, GA 30322 | 2019-06-12 |
| 1891354510 | Gwendolyn Gisiner Gunn | Genetic Counselor, MS | Emory Genetics Clinic, 1365 Clifton Road Ne, Atlanta, GA 30322 | 2019-06-06 |
| 1144710567 | Lisa Cathy-ann Akosa | Registered Nurse | 1365 Cifton Road Ne, Atlanta, GA 30322 | 2018-05-10 |
| 1083118004 | Jessica Milian Keilson | Student in an Organized Health Care Education/Training Program | 1364 Clifton Road Ne, Suite H100, Emory University Hospital Office of Surgical Education, Atlanta, GA 30322 | 2018-03-23 |
| 1568982684 | Jennifer Bilko | Dietitian, Registered | 1365 Clifton Rd., Bldg A, 1st Floor, Suite 1450, Atlanta, GA 30322 | 2017-06-20 |
| 1134652258 | Kassahun Bilcha | Student in an Organized Health Care Education/Training Program | 1525 Clifton Rd Ne Ste 100, Atlanta, GA 30322 | 2017-04-05 |
| 1356872246 | Tova Rogers | Dermatology | 1525 Clifton Road Suite 105, Atlanta, GA 30322 | 2017-03-23 |
| 1194271445 | Dina Amin | Dentist | 1365 Clifton,building B, Oral and Maxillofacial Surgery, Suite 2300, Atlanta, GA 30322 | 2016-08-28 |
| 1427404904 | Rita Kaur Kuwahara | Student in an Organized Health Care Education/Training Program | 100 Woodruff Circle, Suite 327, Atlanta, GA 30322 | 2016-05-13 |
| 1891176251 | Octav Cristea | Transplant Surgery | 1365 Clifton Road Northeast, Building B, 6th Floor, Atlanta, GA 30322 | 2015-06-11 |
| Find all providers in zip 30322 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245838374 | Erica Elizabeth West | Physician Assistant | 1155 Mount Vernon Hwy Ste 101, Atlanta, GA 30338-5439 | 2020-10-12 |
| 1841851680 | Lauren Price Fogarty | Physician Assistant | 5445 Meridian Marks Rd Ste 430, Atlanta, GA 30342-4755 | 2019-06-24 |
| 1417422916 | Alison Miller | Physician Assistant | 993d Johnson Fy Rd Ne, Atlanta, GA 30342-1602 | 2018-10-10 |
| 1588139414 | Tammy May Luu | Physician Assistant | 1150 Hammond Dr Ste 310, Atlanta, GA 30328-7500 | 2018-10-08 |
| 1104323476 | Cody Weldon Howell | Physician Assistant | 303 Parkway Dr Ne # 404, Atlanta, GA 30312-1212 | 2018-04-12 |
| 1659895373 | Sudhisha Kumari Jala | Physician Assistant | 980 Johnson Ferry Rd Ste 820, Atlanta, GA 30342-1608 | 2017-08-03 |
| 1487178893 | Magdalena Kertscher | Physician Assistant | 105 Collier Rd Nw Ste 2010, Atlanta, GA 30309-1734 | 2017-07-27 |
| 1841738044 | Adrienne Anderson | Physician Assistant | 1800 Howell Mill Rd Nw Ste 450, Atlanta, GA 30318-2508 | 2017-02-08 |
| 1730623802 | Catherine Lynn Johnson | Physician Assistant | 1365 Clifton Rd Ne # C, Atlanta, GA 30322-1013 | 2016-12-08 |
| 1649626938 | Alex Phillip Schultz | Physician Assistant | 476 Wilmer St Ne, Unit 1230, Atlanta, GA 30308-2933 | 2016-05-05 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.