Loy C Puckett, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

101050 Issued in MO

Practice address

1515 Union Ave
Moberly, MO 65270-9407

Phone

(660) 269-3157

NPI assigned

Oct 26, 2006

Last updated

Aug 11, 2008By the provider in NPPES

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Moberly HBP Medical Group LLC

  • Emergency Medicine Physician
  • Moberly, MO
  • NPI 1487895082
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218412800000",
    "number": "1831274141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 FALL RIDGE DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652036629",
            "telephone_number": "573-445-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 UNION AVE",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709407",
            "telephone_number": "660-269-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "LOY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "101050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "101050",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "116134",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Preferred Family Healthcare Inc
• Preferred Family Healthcare Inc (Clarity Healthcare)
• Carla Price, R.N., F.N.P.
• Phyllis Prier
• Prime Time Physicians, LLC
• Angela Purdy, PTA
• R.L. Bautista, Inc.
• Jon P Rampton, DO
• Courtney Ramsey, NP
• Randolph County Ambulance District

• Emergency Medicine Physician in Moberly, MO
• Providers in Moberly, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.