KELLI ELIZABETH PRUITT – Family Nurse Practitioner, NPI 1285049254
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,268 NURSE PRACTITIONER in WA
Provider Addresses for KELLI ELIZABETH PRUITT
5512 NE 109th Ct Ste I
Vancouver, WA 986626175
Phone: (360) 200-5273
Type: Location
1529 Simpson Highway 49
Magee, MS 391114209
Phone: (601) 439-7288
Type: Location
PO BOX 23666
JACKSON, MS 392253666
Phone: (601) 200-3100
Fax: (601) 200-8846
Type: Mailing
971 LAKELAND DR
SUITE 657
JACKSON, MS 39216
Phone: (601) 200-2780
Fax: (601) 200-5929
Type: Location
2969 CURRAN DR N
JACKSON, MS 392164121
Phone: (601) 540-5598
Type: Mailing
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: 2014-09-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20140918001483 | I | Nurse Practitioner | MS | 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 |
|---|---|---|---|---|
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 21 | 20 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 21 | 11 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 20 | 19 | $0 |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | 12 | 12 | $0 |
Insurance plans in this area (ZIP 98662)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MS | |
| Nurse Practitioner | MS | |
| Nurse Practitioner | MS | |
| - | AL | |
| Nurse Practitioner | MS | |
| Nurse Practitioner | MS | |
| Nurse Practitioner | MS |
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