MS. AMBER NICOLE PRUITT (NPI# 1679113112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679113112 |
| Entity Type | Individual |
| Full Name | MS. AMBER NICOLE PRUITT |
| Credential | JD |
| Practice Address |
2595 Christie Drive Lake Oswego OR 97034 |
| Mailing Address |
1220 Sw Columbia St Portland OR 97201-3316 |
| Practice Telephone | 5035173950 |
| Mailing Telephone | 5035173950 |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-01-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 1740844539 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033696885 | Amber Michelle Pruitt | Community Health Worker | 3165 Mckelvey Rd Ste 200, Bridgeton, MO 63044-2550 | 2018-07-24 |
| Street Address |
2595 CHRISTIE DRIVE |
| City | LAKE OSWEGO |
| State | OR |
| Zip Code | 97034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194377309 | Robin Donart | Case Manager/Care Coordinator | 2595 Christie Drive, Lake Oswego, OR 97034 | 2019-07-09 |
| 1558901009 | Casey Parks | Case Manager/Care Coordinator | 2595 Christie Drive, Lake Oswego, OR 97034 | 2020-01-13 |
| 1003468216 | Tabitha Alana Jensen | Case Manager/Care Coordinator | 2595 Christie Drive, Lake Oswego, OR 97034 | 2019-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740844539 | New Avenues for Youth | Clinic/Center | 2595 Christie Dr., Lake Oswego, OR 97034 | 2019-04-26 |
| 1366946451 | Kristy Car Makowichuk | Counselor | 630 B Avenue, Suite 9, Lake Oswego, OR 97034 | 2018-03-22 |
| 1861841504 | Soaring Crane Acuouncture LLC | Acupuncturist | 630 B Ave. #3, Lake Oswego, OR 97034 | 2016-06-03 |
| 1679945216 | Guru Sandesh Singh Khalsa | Naturopath | 630 B Avenue, Suite 3, Lake Oswego, OR 97034 | 2015-10-22 |
| 1902208846 | 360 Pediatric Psychology, PC | Clinical Neuropsychologist | 201 B Ave., Suite #285, Lake Oswego, OR 97034 | 2014-09-23 |
| 1275873309 | Sara Elizabeth Forrest | Social Worker | 2507 Christie Dr., Lake Oswego, OR 97034 | 2013-02-27 |
| 1982964631 | Catherine L Morris Daraee | Social Worker | 4040 Douglas Way, Lake Oswego, OR 97034 | 2012-05-29 |
| 1205105244 | Gail E. Barnard | Specialist/Technologist | 1260 Rockinghorse Ln, Lake Oswego, OR 97034 | 2011-12-20 |
| 1306099460 | Corinne Jarvis | Speech-Language Pathologist | 325 3rd Street, Lake Oswego, OR 97034 | 2008-11-02 |
| 1770764797 | Concetta Marie Antonelli | Massage Therapist | 890 Avenue F, Lake Oswego, OR 97034 | 2007-11-19 |
| Find all providers in zip 97034 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194377309 | Robin Donart | Case Manager/Care Coordinator | 2595 Christie Drive, Lake Oswego, OR 97034 | 2019-07-09 |
| 1316087083 | Alisa Plasto | Case Manager/Care Coordinator | 4151 Douglas Way, Lake Oswego, OR 97035-3436 | 2007-02-08 |
| 1558901009 | Casey Parks | Case Manager/Care Coordinator | 2595 Christie Drive, Lake Oswego, OR 97034 | 2020-01-13 |
| 1003468216 | Tabitha Alana Jensen | Case Manager/Care Coordinator | 2595 Christie Drive, Lake Oswego, OR 97034 | 2019-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104539 | Jessica Laine | Case Manager/Care Coordinator | 1724 Maple St Apt 7, North Bend, OR 97459-2171 | 2020-08-14 |
| 1083232862 | Olivia Suzanne Botsford | Case Manager/Care Coordinator | 2369 Nw Schmidt Way Apt 117, Beaverton, OR 97006-4775 | 2020-07-08 |
| 1255958674 | Kathy Hays | Case Manager/Care Coordinator | 17887 Sw Bryan Way, Beaverton, OR 97007-6728 | 2020-07-01 |
| 1437775558 | John Alan Varner | Case Manager/Care Coordinator | 5833 N Lombard St, Portland, OR 97203-4115 | 2020-06-24 |
| 1750906228 | Dwell Care LLC. | Case Manager/Care Coordinator | 1720 Nw Lovejoy St Ste 202, Portland, OR 97209-2341 | 2020-06-10 |
| 1275169393 | Celina N Taylor | Case Manager/Care Coordinator | 103 Or-82, Enterprise, OR 97828 | 2020-03-20 |
| 1710512736 | Dominic Townsend | Case Manager/Care Coordinator | 18715 Sw Blanton St, Aloha, OR 97078-1234 | 2020-03-10 |
| 1659910073 | Kristin Anne Contreras | Case Manager/Care Coordinator | 4850 Sw 11th St Apt 110, Gresham, OR 97080-7312 | 2020-01-02 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1043853716 | Heidi Marie Davis | Case Manager/Care Coordinator | 635 3rd Ave Sw Unit 151, Albany, OR 97321-2625 | 2019-10-24 |
| Find all providers with the same taxonomy | ||||
| City | LAKE OSWEGO |
| Zip Code | 97034 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.