MR. THOMAS EDWIN PUCKETT JR. (NPI# 1346626876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346626876 |
| Entity Type | Individual |
| Full Name | MR. THOMAS EDWIN PUCKETT JR. |
| Credential | N.P. |
| Practice Address |
3834 S Emerson Ave Bldg C Ste 100 Indianapolis IN 46203 |
| Mailing Address |
Po Box 3299 Carson City NV 89702-3299 |
| Practice Telephone | 3177821577 |
| Practice Fax Number | 8883667577 |
| Mailing Telephone | 7752220044 |
| Mailing Fax Number | 8887000187 |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2018-08-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71005644A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201312180 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437584737 | Thomas W Puckett | Social Worker | 3910 S Rural Rd, Suite J, Tempe, AZ 85282-5581 | 2013-09-05 |
| 1841308160 | Thomas G Puckett | Pathology | 421 S 28th Ave, Hattiesburg, MS 39401-7236 | 2006-08-27 |
| Street Address |
3834 S EMERSON AVE BLDG C STE 100 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245229327 | Patrice R Yates | Internal Medicine | 3834 S Emerson Ave, Building C, Suite 100, Indianapolis, IN 46237 | 2005-10-20 |
| 1548776925 | Erin Tofani | Nurse Practitioner | 3834 S Emerson Ave, Building C, Suite 100, Indianapolis, IN 46203 | 2017-12-20 |
| 1114464575 | Abigail G Boris | Registered Nurse | 3834 S Emerson Ave, Bldg C Ste 100, Indianapolis, IN 46203 | 2017-01-24 |
| 1285184481 | Kelli Joy Bovenkerk | Nurse Practitioner | 3834 S Emerson Ave, Building C, Suite 100, Indianapolis, IN 46203 | 2016-10-12 |
| 1083915581 | Bridget A. Witsken | Registered Nurse | 3834 S Emerson Ave, Building C, Suite 100, Indianapolis, IN 46203 | 2010-11-15 |
| 1588818587 | Kayla Lyn Hagerty | Registered Nurse | 3834 S Emerson Ave, Building C, Suite 100, Indianapolis, IN 46203 | 2008-11-05 |
| 1841225091 | Advanced Healthcare Associates LLP | Internal Medicine | 3834 S Emerson Ave, Building C, Suite 100, Indianapolis, IN 46203 | 2006-07-12 |
| 1780625731 | Leo Solito | Internal Medicine | 3834 S Emerson Ave, Building C, Suite 100, Indianapolis, IN 46203 | 2006-06-09 |
| 1912953654 | Ann P Arno | Family Medicine | 3834 S Emerson Ave, Building C, Suite 100, Indianapolis, IN 46203 | 2006-05-25 |
| 1821043977 | Isd Renal Inc | Clinic/Center | 3834 S Emerson Ave, Bldg B, Indianapolis, IN 46203-5902 | 2006-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194362665 | Yvonne Irene Wince | Pharmacist | 608 Twin Aire Dr, Indianapolis, IN 46203 | 2019-12-04 |
| 1730635681 | Kensie Waller | Registered Nurse | 3834 S. Emerson Ave, Bldg C, Ste 100, Indianapolis, IN 46203 | 2016-08-31 |
| 1629285820 | 21st Century Charter School At Fountain Square | Local Education Agency (LEA) | 1615 South Barth Ave, Indianapolis, IN 46203 | 2007-05-17 |
| 1912124918 | Richard Walter James | Chiropractor | 3850 S Emerson, Suite F, Indianapolis, IN 46203 | 2007-04-19 |
| 1245386655 | Gary Richard Billingsley | Chiropractor | 4940 S Emerson Ave, Indianapolis, IN 46203 | 2007-01-26 |
| 1952452815 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 2630 S Keystone Ave, Indianapolis, IN 46203 | 2007-01-16 |
| 1245324755 | Rtc Resource Acq Corp | Residential Treatment Facility, Emotionally Disturbed Children | 1404 South State Avenue, Indianapolis, IN 46203 | 2006-10-02 |
| 1003115957 | Emerson Physical Medicine Inc | Physical Medicine & Rehabilitation | 4625 S Emerson Ave, Indianapolis, IN 46203 | 2011-03-17 |
| 1609921758 | Joan Legree Shemwell | Specialist | 3834 S Emerson Ave Ste 100, Indianapolis, IN 46203 | 2007-01-25 |
| 1659467256 | Options Treatment Acquisition Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1404 South State Avenue, Indianapolis, IN 46203 | 2006-10-04 |
| Find all providers in zip 46203 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
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| 1881200152 | Positive Energy Health Center LLC | Nurse Practitioner | 5023 E 56th St Ste 130, Indianapolis, IN 46226-1471 | 2020-09-21 |
| 1518591023 | Nikki Maxey | Nurse Practitioner | 9302 N Meridian St Ste 235, Indianapolis, IN 46260-1337 | 2020-02-24 |
| 1639701584 | Bindu Neupane Wagle | Nurse Practitioner | 1701 N Senate Ave # Ago69, Indianapolis, IN 46202-5306 | 2020-02-09 |
| 1649810912 | Ashley Nicole Bilen | Nurse Practitioner | 8427 Coppel Ln, Indianapolis, IN 46259-1469 | 2020-01-14 |
| 1164063202 | Katlyn Rader | Nurse Practitioner | 8333 Naab Rd Ste 420, Indianapolis, IN 46260-1992 | 2019-09-30 |
| 1609423680 | Kari Tucker | Nurse Practitioner | 8435 Keystone Xing Ste 108, Indianapolis, IN 46240-4373 | 2019-08-23 |
| 1598320566 | The Health and Hospital Corporation of Marion County | Nurse Practitioner | 9165 Otis Ave Ste 112, Indianapolis, IN 46216-2311 | 2019-05-06 |
| 1841855897 | The Health and Hospital Corporation of Marion County | Nurse Practitioner | 6920 Parkdale Pl Ste 107, Indianapolis, IN 46254-5604 | 2019-05-06 |
| 1073178059 | The Health and Hospital Corporation of Marion County | Nurse Practitioner | 2506 Willowbrook Pkwy Ste 299, Indianapolis, IN 46205-1548 | 2019-05-06 |
| 1215406699 | Michele Dawn Cambridge | Nurse Practitioner | 7007 Graham Rd Ste 215, Indianapolis, IN 46220-4063 | 2018-11-15 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46203 |
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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.