Kennedi Elizabeth Puckett, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1110 N Lee Ave Ste 300
Oklahoma City, OK 73103-2612

Phone

(405) 231-3000

NPI assigned

Apr 4, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpuckett513710@direct-ehr-ssmhc.com

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.

• Saints Medical Group, LLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1437195922
  Medicare reassignment Care Compare group NPD
• Williams Medical Group Practice, LLC

  dba Integrity Urgent Care

  • Family Medicine Physician
  • Lawton, OK
  • NPI 1346608809
  Medicare reassignment NPD
• Saints Medical Group, LLC

  dba SSM Health Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Edmond, OK
  • NPI 1730907700
  NPD
• Williams Medical Group Practice, LLC

  dba Xpress Wellness Urgent Care

  • Rural Health Clinic/Center
  • Collinsville, OK
  • NPI 1215751508
  NPD
• SSM Health Care of Oklahoma, Inc.

  dba SSM Health St. Anthony Hospital - Oklahoma City

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1366545311
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Health Care of Oklahoma Inc

  dba SSM Health Pharmacy

  • Community/Retail Pharmacy
  • Oklahoma City, OK
  • NPI 1649602293

  Hospital

  Care Compare affiliation
• SSM Health Care of Oklahoma, Inc.

  dba SSM Health St. Anthony Hospital - Oklahoma City

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1366545311
  Care Compare affiliation

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1861197295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 NW 144TH ST",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730994731",
            "telephone_number": "918-869-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N LEE AVE STE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731032612",
            "telephone_number": "405-231-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "KENNEDI",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PTMS 3.0, LLC (Physical Therapy Central of NW OKC)
• Public Strategies, Inc. (Neighborhood Strategies)
• Cynthia Diane Puckett, OTR/L
• Dusti D Puckett, M.S., CCC/SLP
• Elizabeth Puckett
• Timothy A Puckett, MD
• Tony G Puckett, MD
• Joseph Brandon Pueblo
• Kristen Puente, RD, LD
• William R Puffinbarger, MD

• Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.