ANNA DAVENPORT SHEALY PRUITT PA-C
NPI 1821689068
Physician Assistant in Charlotte, NC

Q: What is Anna Pruitt's NPI number?

The NPI number for Anna Pruitt is 1821689068. It was assigned to this individual provider in the NPPES registry on January 31, 2021. The provider is also known as Anna Davenport Shealy.

Q: What is Anna 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 Anna Pruitt was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 January 31, 2021PECOS EnrolledAccepts Medicare Assignment

5821 FAIRVIEW RD STE 106, CHARLOTTE, NC 28209(704) 826-3550(704) 538-4135 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 21, 2025, May 6, 2024, Jan 31, 2021 (3 updates tracked since 2021).

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About Anna Davenport Shealy Pruitt Pa-c NPPES

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

ANNA DAVENPORT SHEALY PRUITT PA-C (NPI 1821689068) is an individual physician assistant in Charlotte, North Carolina, licensed in North Carolina (0010-12215) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1821689068

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameANNA DAVENPORT SHEALY PRUITTCredential: PA-C

Location Address5821 FAIRVIEW RD STE 106Charlotte, NC 28209-3649

Mailing Address4705 University Dr Bldg 700Durham, NC 27707-3489 · (484) 900-1317 · Fax (866) 538-4716

Phone(704) 826-3550

Fax(704) 538-4135

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJanuary 31, 2021

Last NPPES UpdateMay 21, 20253 updates tracked since enumeration

NPPES CertifiedMay 21, 2025

✔ NPI 1821689068 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 NC · 0010-12215

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.

5821 FAIRVIEW RD STE 106, Charlotte, NC 28209

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Other Names 1

Former Name (1)Anna Davenport Shealy

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

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

Anna Davenport Shealy Pruitt Pa-c 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 ID42739435

PECOS Enrollment IDI20250529000730

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28209 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

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 8

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

DR. MARY GREEN KNOX M.D.

Family Medicine