Jade Isis Puckett, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1185668 Issued in TX

Practice address

6081 Trent CT
League City, TX 77573-6539

Phone

(832) 260-8993

Fax

(832) 426-0299

NPI assigned

Aug 15, 2011

Last updated

Aug 15, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1568741031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6081 TRENT CT",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775736539",
            "telephone_number": "832-260-8993",
            "fax_number": "832-426-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6081 TRENT CT",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775736539",
            "telephone_number": "832-260-8993",
            "fax_number": "832-426-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "JADE",
        "middle_name": "ISIS",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-15",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1185668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "1185668",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Travis William Prothro, DC
• Zelma Sue Pruitt-Willke, L.C.D.C.
• Kimberly Pruitt
• Psychology Resources, PC
• Alisha Puckett, PTA
• Ashley Pugh, DPT
• Eugene John Pugh, M.A., BCBA
• Julie Lynne Pugh
• Christopher J. Pulido, D.C.
• Kayla Purnell

• Physical Therapist in League City, TX
• Providers in League City, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.