MR. STANLEY JAMAR PRUITT (NPI# 1396801957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396801957 |
Entity Type | Individual |
Full Name | MR. STANLEY JAMAR PRUITT |
Practice Address |
35510 N Belgian Blue Ct Queen Creek AZ 85243-5518 |
Practice Telephone | 6193708544 |
Practice Fax Number | 4806415768 |
Mailing Telephone | 6193708544 |
Mailing Fax Number | 4806415768 |
Enumeration Date | 2006-12-28 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
Respite Care Facility |
Street Address |
35510 N BELGIAN BLUE CT |
City | QUEEN CREEK |
State | AZ |
Zip Code | 85243-5518 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811250301 | Skyline Dental Group and Orthodontics, LLP | Dentist | 1714 West Hunt Hwy, Suite 100, Queen Creek, AZ 85243 | 2012-06-19 |
1467672386 | Copper Dental Management | Dentist | 2510 E Hunt Highway, #28, Queen Creek, AZ 85243 | 2007-04-26 |
1346387404 | Joseph Timbre | Optometrist | 1725 W Hunt Highway, Queen Creek, AZ 85243 | 2007-01-30 |
1801942636 | Diane R Kuhlmann | Licensed Practical Nurse | 1084 W San Tan Hills, Queen Creek, AZ 85243 | 2007-01-26 |
1285798678 | Annette Winsor | Technician | 184 E Piccolo Ct, Queen Creek, AZ 85243 | 2006-12-20 |
1972675031 | Patricia Ellen Keaton | Technician | 31317 N Blackfoot Dr, Queen Creek, AZ 85243 | 2006-11-14 |
1134366065 | Abby Mcneil | Occupational Therapist | 31437 N Desert Star Dr, Queen Creek, AZ 85243-3046 | 2009-01-14 |
1265694012 | Walter M Dise | Non-emergency Medical Transport (VAN) | 34095 N Slate Creek Dr, Queen Creek, AZ 85243-3420 | 2008-07-01 |
1700070489 | John David Mather | Clinical Neuropsychologist | 1084 San Tan Hills Dr, Queen Creek, AZ 85243-3489 | 2007-09-05 |
1629233507 | Sellner Home Care LLC | Hospice Care, Community Based | 775 W Desert Canyon Dr, Queen Creek, AZ 85243-3515 | 2008-07-21 |
Find all providers in zip 85243 |
Taxonomy Code | 385HR2055X |
Grouping | Respite Care Facility |
Classification | Respite Care |
Specialization | Respite Care, Mental Illness, Child |
A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972163293 | Harold Kilgore | Respite Care | 3734 E Longhorn St, Queen Creek, AZ 85140-4303 | 2019-06-18 |
1932567229 | Adriana Ratzlaff | Respite Care | 20820 E Pickett St, Queen Creek, AZ 85142-9533 | 2016-02-02 |
1073748463 | Noel I Vandyke | Respite Care | 3542 E Amarillo Way, Queen Creek, AZ 85240-4320 | 2009-05-28 |
1700038262 | Lonnie L Bellamy | Respite Care | 18611 E Swan Dr, Queen Creek, AZ 85242-5148 | 2008-10-15 |
1548326085 | Todd Kemmerer | Respite Care | 861 E Chelsea Dr, Queen Creek, AZ 85242-5658 | 2006-12-29 |
1407912298 | Jeffrey J. Hamilton | Respite Care | 2712 W Gold Dust Ave, Queen Creek, AZ 85242-6725 | 2006-12-28 |
1639243512 | Gregory Tarazon | Respite Care | 2019 W Vineyard Plains Dr, Queen Creek, AZ 85242-6378 | 2006-11-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114539004 | Yvette I Haughton | Respite Care | 11275 N 99th Ave Lot 117, Peoria, AZ 85345-5479 | 2020-08-20 |
1700411576 | Jaquelina Andrea Reyes | Respite Care | 25279 W Centre Ave, Buckeye, AZ 85326-2468 | 2020-03-11 |
1740815497 | Jerome Alexander-terrell Jackson | Respite Care | 9680 W Northern Ave Unit 2311, Peoria, AZ 85345-4655 | 2020-03-03 |
1912539941 | Elizabeth Ann Mannel | Respite Care | 1225 W Panorama Rd, Tucson, AZ 85704-2834 | 2020-02-07 |
1093345498 | New Hope of Arizona, Inc. | Respite Care | 12545 W Woodland Ave, Avondale, AZ 85323-8025 | 2020-01-24 |
1033757877 | Jessica Annette Dixon-tatum | Respite Care | 401 N 6th St, Buckeye, AZ 85326-2415 | 2019-12-11 |
1700423902 | Randy Bland | Respite Care | 20731 W Stone Hill Road, Buckeye, AZ 85396 | 2019-12-06 |
1003459934 | Stephanie Denise Jackson | Respite Care | 22321 W Morning Glory St, Buckeye, AZ 85326-7181 | 2019-10-23 |
1285276345 | Charlyn Ponds | Respite Care | 235 E Ray Rd Apt 2035, Chandler, AZ 85225-3362 | 2019-10-10 |
1508416595 | Tyechia Webb | Respite Care | 21239 N 24th Ave Apt 214, Phoenix, AZ 85027-2524 | 2019-09-12 |
Find all providers with the same taxonomy |
City | QUEEN CREEK |
Zip Code | 85243 |
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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.