Kelly Elizabeth Pruitt, FNP-BC is a medicare enrolled "Family Medicine" in Rainbow City, Alabama. Her current practice location is
3500 Rainbow Dr, Rainbow City, Alabama. You can reach out to her office (for appointments etc.) via phone at
(256) 442-3208.
Kelly Elizabeth Pruitt is licensed to practice in Alabama (license number 1-122055) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1447979638.
Provider's Profile
| Full Name | Kelly Elizabeth Pruitt |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 3500 Rainbow Dr, Rainbow City, Alabama |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1447979638
- Provider Enumeration Date: 08/23/2022
- Last Update Date: 07/16/2024
Medicare PECOS Information:
- PECOS PAC ID: 3476939018
- Enrollment ID: I20221005000000
Medical Identifiers
Medical identifiers for Kelly Elizabeth Pruitt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1447979638 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | 1-122055 (Alabama) | Secondary |
| 207Q00000X | Family Medicine | 1-122055 (Alabama) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly Elizabeth Pruitt allows following entities to bill medicare on her behalf.
| Entity Name | Southern Np Associates Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1407257447
PECOS PAC ID: 1557686243
Enrollment ID: O20150223000847 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Elizabeth Pruitt is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kelly Elizabeth Pruitt, FNP-BC
105 County Road 936,
Centre, AL 35960-8638
Ph: (256) 304-4167 | Kelly Elizabeth Pruitt, FNP-BC
3500 Rainbow Dr,
Rainbow City, AL 35906-6310
Ph: (256) 442-3208 |
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