Jake Puckett, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

008866 Issued in KY

Practice address

1212 Market St
La Grange, KY 40031-7986

Phone

(502) 225-9981

NPI assigned

Aug 3, 2023

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

Enrolled in KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SN Kentuckiana Rehab, LLCGroup PAC ID 1254671464, 339 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• SN Kentuckiana Rehab, LLC

  • Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1609349018

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• SN Kentuckiana Rehab, LLC

  • Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1326653080
  NPD
• SN Kentuckiana Rehab, LLC

  • Rehabilitation Clinic/Center
  • Jeffersonville, IN
  • NPI 1851864169
  NPD

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1700568375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 MARKET ST",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400317986",
            "telephone_number": "502-225-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 MARKET ST",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400317986",
            "telephone_number": "502-225-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "JAKE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-03",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "008866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Price
• Timothy G Price, MD
• Morgan Profitt, OTR/L
• Prorehab Louisville, LLC
• Shelby Pryor
• Paula Faye Rabbeth, OT
• Angela Ann Rabeneck, OTR/L
• Cassidy Nicole Raibert, PT, DPT, NCS
• Emily Rae Rankin, SLP
• Cassidy Layne Ratliff

• Physical Therapist in La Grange, KY
• Providers in La Grange, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.