Revonda Kiser Pruitt, MS CCC-SLP is a medicare enrolled "Speech-language Pathologist" provider in Piedmont, Alabama. Her current practice location is
502 W Hood St, Piedmont, Alabama. You can reach out to her office (for appointments etc.) via phone at
(256) 447-9481.
Revonda Kiser Pruitt is licensed to practice in Alabama (license number 1685) 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 1255814851.
Healthcare Provider's Profile
| Full Name | Revonda Kiser Pruitt |
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| Gender | Female |
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| Speciality | Speech-language Pathologist |
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| Location | 502 W Hood St, Piedmont, 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: 1255814851
- Provider Enumeration Date: 09/10/2018
- Last Update Date: 09/10/2018
Medicare PECOS Information:
- PECOS PAC ID: 8729324124
- Enrollment ID: I20190104003006
Medical Identifiers
Medical identifiers for Revonda Kiser Pruitt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1255814851 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 235Z00000X | Speech-language Pathologist | 1685 (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. Revonda Kiser Pruitt allows following entities to bill medicare on her behalf.
| Provider Name | Helping Hands Therapy |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1497871495
PECOS PAC ID: 8224180500
Enrollment ID: O20090717000062 |
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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. Revonda Kiser 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 |
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Revonda Kiser Pruitt, MS CCC-SLP
11310 Us Highway 278 E,
Piedmont, AL 36272-8365
Ph: (256) 310-9352 | Revonda Kiser Pruitt, MS CCC-SLP
502 W Hood St,
Piedmont, AL 36272-1530
Ph: (256) 447-9481 |
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