Dannielle Rose Puckett, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

001447 Issued in GA

Practice address

301 Margie Dr
Warner Robins, GA 31088-7818

Phone

(478) 953-5800

Fax

(478) 953-5800

NPI assigned

Dec 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Dannielle Rose Humphrey Former name

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": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1639353261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MARGIE DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310887818",
            "telephone_number": "478-953-5800",
            "fax_number": "478-953-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MARGIE DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310887818",
            "telephone_number": "478-953-5800",
            "fax_number": "478-953-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "DANNIELLE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "001447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANNIELLE",
            "last_name": "HUMPHREY",
            "middle_name": "ROSE",
            "prefix": "MRS.",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapy Assistant in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.