NPI Code Detail JSON Logo

1295611374 NPI number — DENNIS M PRUITT SR.

NPI Number: 1295611374
Health Care Provider/Practitioner: DENNIS M PRUITT SR.

Information about “1295611374” NPI (DENNIS M PRUITT SR.) exists in 1295611374 in HTML format HTML  |  1295611374 in plain Text format TXT  |  1295611374 in PDF (Portable Document Format) PDF  |  1295611374 in an XML format XML  formats.

NPI Number : 1295611374 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295611374",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PRUITT",
    "FirstName": "DENNIS",
    "MiddleName": "M",
    "NamePrefix": null,
    "NameSuffix": "SR.",
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "390 THOMAS ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ATOKA",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "38004-7172",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "901-900-0281",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "390 THOMAS ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ATOKA",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "38004-7172",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "901-900-0281",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/13/2025",
    "LastUpdateDate": "10/11/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "104100000X",
          "TaxonomyName": "Social Worker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "171M00000X",
          "TaxonomyName": "Case Manager/Care Coordinator",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103K00000X",
          "TaxonomyName": "Behavior Analyst",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "376G00000X",
          "TaxonomyName": "Nursing Home Administrator",
          "LicenseNumber": "4492",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP1600X",
          "TaxonomyName": "Pastoral Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101200000X",
          "TaxonomyName": "Drama Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YS0200X",
          "TaxonomyName": "School Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "183700000X",
          "TaxonomyName": "Pharmacy Technician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.