BRETT DANIEL PUCKETT (NPI# 1265830152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265830152 |
| Entity Type | Individual |
| Full Name | BRETT DANIEL PUCKETT |
| Credential | MS, ATC |
| Practice Address |
1364 Clifton Rd Ne Atlanta GA 30322 |
| Mailing Address |
1364 Clifton Rd Ne Atlanta GA 30322-1059 |
| Practice Telephone | 4047277825 |
| Mailing Telephone | 8123609068 |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2019-09-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
36002274A | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1364 Clifton Rd Ne, Atlanta, GA 30322 | 4047277825 | |
| 7001 W 56th St, Indianapolis, IN 462549725 | 8123609068 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831150960 | Brett Christopher Puckett | Orthopaedic Surgery | 2627 Riverside Ave, Suite 300, Jacksonville, FL 32204-4712 | 2006-03-29 |
| Street Address |
1364 CLIFTON RD NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669476248 | Maureen E. Haas | Pharmacist | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2005-06-10 |
| 1730789900 | Gina Renae Martin | Student in an Organized Health Care Education/Training Program | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-10-28 |
| 1053919878 | Yolanda Martin | Nurse Practitioner | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-10-14 |
| 1508463175 | Federico Andres Napoli | Student in an Organized Health Care Education/Training Program | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-10-06 |
| 1871109330 | Jazmynn Lee Orellana-noia | Nurse Practitioner | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-09-21 |
| 1376156562 | Monica Fajobi | Nurse Practitioner | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-08-26 |
| 1174135586 | Robert Achram | Student in an Organized Health Care Education/Training Program | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-08-18 |
| 1336751932 | Michel Attieh | Pathology | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-08-17 |
| 1346851417 | Tatiana Tvrdik | Pathology | 1364 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-08-12 |
| 1710596333 | Juna Victoria Konomi Johnson | Anesthesiologist Assistant | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445830 | Justin Gill | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Clinic B - Suite B6100, Atlanta, GA 30322 | 2019-06-12 |
| 1891354510 | Gwendolyn Gisiner Gunn | Genetic Counselor, MS | Emory Genetics Clinic, 1365 Clifton Road Ne, Atlanta, GA 30322 | 2019-06-06 |
| 1144710567 | Lisa Cathy-ann Akosa | Registered Nurse | 1365 Cifton Road Ne, Atlanta, GA 30322 | 2018-05-10 |
| 1083118004 | Jessica Milian Keilson | Student in an Organized Health Care Education/Training Program | 1364 Clifton Road Ne, Suite H100, Emory University Hospital Office of Surgical Education, Atlanta, GA 30322 | 2018-03-23 |
| 1568982684 | Jennifer Bilko | Dietitian, Registered | 1365 Clifton Rd., Bldg A, 1st Floor, Suite 1450, Atlanta, GA 30322 | 2017-06-20 |
| 1134652258 | Kassahun Bilcha | Student in an Organized Health Care Education/Training Program | 1525 Clifton Rd Ne Ste 100, Atlanta, GA 30322 | 2017-04-05 |
| 1356872246 | Tova Rogers | Dermatology | 1525 Clifton Road Suite 105, Atlanta, GA 30322 | 2017-03-23 |
| 1194271445 | Dina Amin | Dentist | 1365 Clifton,building B, Oral and Maxillofacial Surgery, Suite 2300, Atlanta, GA 30322 | 2016-08-28 |
| 1427404904 | Rita Kaur Kuwahara | Student in an Organized Health Care Education/Training Program | 100 Woodruff Circle, Suite 327, Atlanta, GA 30322 | 2016-05-13 |
| 1891176251 | Octav Cristea | Transplant Surgery | 1365 Clifton Road Northeast, Building B, 6th Floor, Atlanta, GA 30322 | 2015-06-11 |
| Find all providers in zip 30322 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417563909 | Josephine Almanzar | Student in an Organized Health Care Education/Training Program | 199 Armour Dr Ne Ste E, Atlanta, GA 30324-3973 | 2020-09-20 |
| 1013532597 | Ivy Elizabeth Cook | Student in an Organized Health Care Education/Training Program | 3121 Flowers Rd S Apt I, Atlanta, GA 30341-5648 | 2020-06-10 |
| 1265055495 | Jeffrey Quinn Taylor II | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne # 2300b, Atlanta, GA 30322-1013 | 2020-05-21 |
| 1073134391 | Robert Shvarts | Student in an Organized Health Care Education/Training Program | 465 Memorial Dr Se Unit 346, Atlanta, GA 30312-2229 | 2020-04-27 |
| 1477173920 | Ryan William Flanagan | Student in an Organized Health Care Education/Training Program | 2591 Piedmont Rd Ne Apt 1531, Atlanta, GA 30324-6280 | 2020-04-24 |
| 1467071589 | Charles Thomas Reeder | Student in an Organized Health Care Education/Training Program | 1744 Logans Knl Ne, Atlanta, GA 30329-4100 | 2020-04-09 |
| 1548899743 | Chandni Patel | Student in an Organized Health Care Education/Training Program | 700 14th St Nw, Atlanta, GA 30318-5408 | 2020-04-08 |
| 1962031625 | Rachel Reed | Student in an Organized Health Care Education/Training Program | 1364 Clifton Rd Ne Ste H-100, Atlanta, GA 30322-1059 | 2020-04-05 |
| 1629606264 | Jasmine Donesha Shackelford | Student in an Organized Health Care Education/Training Program | Emory Family Medicine, 4500 North Shallowford Road, Atlanta, GA 30338 | 2020-03-30 |
| 1467080218 | Aminah Danielle Phelps | Student in an Organized Health Care Education/Training Program | 395 Saint Jacques Ct Sw, Atlanta, GA 30331-8434 | 2020-03-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.