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

Sex

Female

Sole proprietor

No

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

• Physical Therapy Group, Inc

  • Physical Therapy Clinic/Center
  • Louisville, KY
  • NPI 1871620104

  KY

  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)

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 27, 2019.

{
    "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
• Kimberly Dean Patterson
• Kelli L Puckett, LMT
• Allie Roberts
• Patricia Roberts
• Erica Ryan Sparks, DMD
• Wayne D. Sparrow
• James Drane Stephens, RPH

• All providers in Eminence, KY
• 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.