Tracee Pugh

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11287 Issued in TN

Practice address

1991 Pickens Rd
Clarksville, TN 37040-6022

Phone

(931) 624-0014

NPI assigned

Jun 1, 2017

Last updated

Aug 15, 2022By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Physiotherapy LLCGroup PAC ID 8426403247, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Legacy Physiotherapy LLC

  dba Legacy PT

  • Physical Therapist
  • Clarksville, TN
  • NPI 1851019095
  Medicare reassignment Care Compare group NPD Authorized official
• Empower Pelvic Therapy LLC

  • Physical Therapy Clinic/Center
  • Clarksville, TN
  • NPI 1063250959
  NPD (past)

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1689102873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 PICKENS RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406022",
            "telephone_number": "931-624-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 PICKENS RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406022",
            "telephone_number": "931-624-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "TRACEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "11287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0446631",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Publix Tennessee, LLC (Publix Pharmacy #1648)
• Tanisha Danielle Puckett
• Karlee Brooke Pulley
• Krystal Lynn Pulley, R.N.
• Pure Divine Independent Care LLC
• Pure Love Supported Living LLC
• Samantha Purpora, DPT

• Physical Therapist in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.