Tessa D. Marie Puckett, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

006000 Issued in KY

Practice address

151 E Broadway St Ste B
Eminence, KY 40019

Phone

(502) 845-0005

Fax

(502) 845-0006

NPI assigned

Feb 6, 2012

Last updated

Jul 27, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physical Therapy Group, Inc

  • Physical Therapy Clinic/Center
  • Louisville, KY
  • NPI 1871620104
  Medicare reassignment NPD
• PT Pros, Inc.

  • Physical Therapist
  • Barbourville, KY
  • NPI 1366549370
  NPD (past)
• PT Pros, Inc.

  • Physical Therapist
  • Lafayette, LA
  • NPI 1164153839
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564185600000",
    "number": "1154693141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 E BROADWAY ST STE B",
            "city": "EMINENCE",
            "state": "KY",
            "postal_code": "400191149",
            "telephone_number": "502-845-0005",
            "fax_number": "502-548-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E BROADWAY ST STE B",
            "city": "EMINENCE",
            "state": "KY",
            "postal_code": "40019",
            "telephone_number": "502-845-0005",
            "fax_number": "502-845-0006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4233 Bardstown Rd Ste 100C",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402183263",
            "country_code": "US",
            "telephone_number": "502-493-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4233 Bardstown Rd Ste 100C",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402183263",
            "country_code": "US",
            "telephone_number": "502-493-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "TESSA",
        "middle_name": "D. MARIE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-06",
        "last_updated": "2019-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "006000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David A Maddox, MD
• Jessica Elaine McAllister
• Park Duvalle Community Health Center, Inc (Henry County Community Health Center)
• Kimberly Dean Patterson
• Kelli L Puckett, LMT
• Patricia Roberts
• Erica Ryan Sparks, DMD
• Wayne D. Sparrow
• James Drane Stephens, RPH
• Keelie Tillett, APRN

• Physical Therapist in Eminence, KY
• Providers in Eminence, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.