Katherine Ann Puckett, BS, SIT

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

540 3Rd St
Idaho Falls, ID 83404

Phone

(208) 524-5607

Fax

(208) 524-0636

NPI assigned

Jul 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Katherine Ann Calabro Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1366964736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 3RD ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834013953",
            "telephone_number": "208-524-5607",
            "fax_number": "208-524-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 3RD ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-524-5607",
            "fax_number": "208-524-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "BS, SIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "CALABRO",
            "middle_name": "ANN",
            "credential": "BS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Proventures LLC
• Psychological Preventative Health PLLC
• Psychological Service Associates
• Psychology Center of Idaho Falls
• PT Medical LLC
• Zachary Lynn Pugmire, DPT
• Gary Kevin Pullen, RPH
• Catherine Ann Purser, NP
• Casey Puzey, LCPC
• Tanner Puzey, DO

• Case Manager/Care Coordinator in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Case Manager/Care Coordinator in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.