NPIMap

Individual provider Active NPI

Dean Puckett

  • Health Educator
  • Saint Louis, MO
National Provider Identifier
1922471622
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
License
MONAVD3300006 Issued in MO
Practice address
1027 S Vandeventer Ave Ste 700
Saint Louis, MO 63110-3842
Phone
(314) 203-1431
NPI assigned
Nov 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X MONAVD3300006 MO Primary

Addresses

Primary practice location

1027 S Vandeventer Ave Ste 700
Saint Louis, MO 63110-3842

Mailing address

1027 S Vandeventer Ave Ste 700
Saint Louis, MO 63110-3842
Phone (314) 203-1431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MONAVD3300006MOMDHealth Educator

Practice roles

OrganizationSpecialtyStatusNew patients
St. Louis Effort for AIDS Past Accepting new patients
St Louis Effort for AIDS Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1922471622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 S VANDEVENTER AVE STE 700",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631103842",
            "telephone_number": "314-203-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 S VANDEVENTER AVE STE 700",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631103842",
            "telephone_number": "314-203-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "DEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "MO",
            "license": "MONAVD3300006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.