MRS. KELLY SHEPPARD PRUITT LCMHC
NPI 1962172916
Counselor - Mental Health in Winston Salem, NC
About Mrs. Kelly Sheppard Pruitt Lcmhc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KELLY SHEPPARD PRUITT LCMHC (NPI 1962172916) is an individual mental health provider in Winston Salem, North Carolina, licensed in North Carolina (12644) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Winston Salem, and is a graduate of Other (2013).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Kelly Sheppard Pruitt Lcmhc 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.
Medicare Billing Reassignment
Medicare enrollment records show Kelly Pruitt reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Durham, NC 27713
- Reassigned Medicare billing, North Carolina enrollment
- 32 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WINSTON SALEM, NC 27103
WINSTON SALEM, NC 27103
WINSTON SALEM, NC 27103
WINSTON SALEM, NC 27103
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Pruitt's NPI number?
The NPI number for Kelly Pruitt is 1962172916. It was assigned to this individual provider in the NPPES registry on September 20, 2021.
Where is Kelly Pruitt located?
Kelly Pruitt practices at 1255 Creekshire Way Ste 270, Winston Salem, NC 27103. The listed phone number is (336) 283-4757.
What is Kelly Pruitt's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Kelly Pruitt enrolled in Medicare?
Yes. Kelly Pruitt is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kelly Pruitt's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Pruitt reassigns Medicare benefits to Animo Sano Psychiatry PLLC (Durham, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Pruitt's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Pruitt accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC and 3 other insurers list Kelly Pruitt as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kelly Pruitt was last updated on September 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.
# Mrs. Kelly Sheppard Pruitt, LCMHC · NPI 1962172916
Mental Health provider in Winston Salem, North Carolina. Individual provider, active in the CMS NPPES registry since September 20, 2021.
## Identity
- **NPI:** 1962172916 (Entity type: Individual)
- **Enumerated:** September 20, 2021
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 12644 (North Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 1255 CREEKSHIRE WAY STE 270, Winston Salem, NC 27103-3061
- **Phone:** (336) 283-4757
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Animo Sano Psychiatry PLLC (NPI 1568043537, Durham, NC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2013
## Record status
- **NPPES last updated:** September 20, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1962172916) · Data from the CMS NPPES public registry.