{
"Npi": {
"NPI": "1568984656",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PRUITTHEALTH HOME HEALTH, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1626 JEURGENS CT",
"SecondLineMailingAddress": "LEGAL DEPT",
"MailingAddressCityName": "NORCROSS",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30093-2219",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "770-279-6200",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1393 CARROLLTON CROSSING DR STE 104",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KERNERSVILLE",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27284-3896",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "336-515-1491",
"PracticeLocationAddressFaxNumber": "336-992-1106",
"EnumerationDate": "07/11/2017",
"LastUpdateDate": "10/20/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PRUITT",
"AuthorizedOfficialFirstName": "NEIL",
"AuthorizedOfficialMiddleName": "L.",
"AuthorizedOfficialTitle": "CHAIRMAN AND CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "770-279-6200",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}