Terry John Puchalla, RDMS

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

License

108145 Issued in MN

Practice address

720 Highway 10 S
Saint Cloud, MN 56304-1800

Phone

(320) 253-9454

Fax

(320) 253-9454

NPI assigned

Jun 28, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386841971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HIGHWAY 10 S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563041800",
            "telephone_number": "320-253-9454",
            "fax_number": "320-253-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 HIGHWAY 10 S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563041800",
            "telephone_number": "320-253-9454",
            "fax_number": "320-253-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCHALLA",
        "first_name": "TERRY",
        "middle_name": "JOHN",
        "credential": "RDMS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "MN",
            "license": "108145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sonography Radiologic Technologist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Sonography Radiologic Technologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.