JORDAN PRUITT PA
NPI 1033909130
Physician Assistant in Gainesville, GA

Q: What is Jordan Pruitt's NPI number?

The NPI number for Jordan Pruitt is 1033909130. It was assigned to this individual provider in the NPPES registry on May 12, 2025.

Q: What is Jordan Pruitt's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Jordan Pruitt was last updated on July 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 12, 2025PECOS EnrolledAccepts Medicare Assignment

1439 JESSE JEWELL PKWY NE STE 302, GAINESVILLE, GA 30501(770) 219-9200 Get Directions Write a Review

NPPES record last updated: July 29, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Jordan Pruitt Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN PRUITT PA (NPI 1033909130) is an individual physician assistant in Gainesville, Georgia, licensed in Georgia (13282) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and maintains a secondary practice location in Gainesville.

NPPES Registry Identity

NPI1033909130

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameJORDAN PRUITTCredential: PA

Location Address1439 JESSE JEWELL PKWY NE STE 302Gainesville, GA 30501-3806

Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420

Phone(770) 219-9200

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateMay 12, 2025

Last NPPES UpdateJuly 29, 2025

NPPES CertifiedJuly 29, 2025

✔ NPI 1033909130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in GA · 13282

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1439 JESSE JEWELL PKWY NE STE 302, Gainesville, GA 30501

Open in Google Maps ↗

Secondary Practice Location 1

Location 15833 Stratford DrGainesville, GA 30506-3446 · Phone (678) 997-1060

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jordan Pruitt Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082118799

PECOS Enrollment IDI20250916004789

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number110029

Location743 Spring StreetGainesville, GA 30501 · Hall County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$66.89 typical visit price

range $16.68 – $133.24

Typical copayment $16.72 (range $4.17 – $33.31)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANGEL NICHOLS PA

Physician Assistant