Active NPI
John Martin Puckett, LMT
- Contractor
- Mount Orab, OH
National Provider Identifier
1396981908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 015389
- Practice address
- 453 West Main Street
Mount Orab, OH 45154 - Phone
- (937) 783-4535
- Fax
- (937) 783-0009
- NPI assigned
- Jan 2, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 015389 | OH | Primary |
Addresses
Primary practice location
453 West Main Street
Mount Orab, OH 45154
Mailing address
661 West Main Street
Blanchester, OH 45107
Phone (937) 783-4535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015389 | OH | MD | Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthquest of Mt Orab Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Mount Orab, OH
- NPI 1679676993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230854400000",
"number": "1396981908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "661 WEST MAIN STREET",
"city": "BLANCHESTER",
"state": "OH",
"postal_code": "45107",
"telephone_number": "937-783-4535",
"fax_number": "937-783-0009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "453 WEST MAIN STREET",
"city": "MOUNT ORAB",
"state": "OH",
"postal_code": "45154",
"telephone_number": "937-783-4535",
"fax_number": "937-783-0009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUCKETT",
"first_name": "JOHN",
"middle_name": "MARTIN",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-02",
"last_updated": "2009-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "OH",
"license": "015389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Orab, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.