JIMMY DANIEL PRUITT (MD) – Family Medicine Physician, NPI 1346298262
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,514 EMERGENCY MEDICINE in GA
Provider Addresses for JIMMY DANIEL PRUITT (MD)
5610 Bethelview Rd Ste 500A
Cumming, GA 300407530
Phone: (770) 205-2804
Fax: (770) 205-2854
Type: Location
5610 BETHELVIEW RD STE 500A
CUMMING, GA 300407530
Phone: (770) 205-2804
Fax: (770) 205-2854
Type: Mailing
1968 PEACHTREE RD NW
ATLANTA, GA 303091281
Phone: (404) 605-3580
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-10-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040713000784 | I | Emergency Medicine | GA | TBD |
| I20081027000130 | I | Emergency Medicine | AL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 19 | 19 | $0 |
Insurance plans in this area (ZIP 30040)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| - | MN | |
| Nurse Practitioner | GA | |
| Physician Assistant | GA | |
| - | UT | |
| G A S T R O E N T E R O L O G Y | GA | |
| - | GA | |
| - | GA | |
| Physician Assistant | GA | |
| Nurse Practitioner | GA |
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