DR. THOMAS CHILDS PUCKETTE (NPI# 1356350144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356350144 |
| Entity Type | Individual |
| Full Name | DR. THOMAS CHILDS PUCKETTE |
| Practice Address |
1241 Woodland Avenue Mount Pleasant SC 29464 |
| Practice Telephone | 8438240606 |
| Practice Fax Number | 8438240909 |
| Mailing Telephone | 8438240606 |
| Mailing Fax Number | 8438240909 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2008-06-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
ME17812 | SC | Allopathic & Osteopathic Physicians |
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
ME17812 | SC | Allopathic & Osteopathic Physicians |
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
ME17812 | SC | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME17812 | SC | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
ME17812 | SC | Allopathic & Osteopathic Physicians |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
ME17812 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICARE GROUP | 1709 | 01 |
| MEDICARE RR | 300125235 | 01 | |
| FIRST HEALTH | 1138590 | 01 | |
| SC | T17906 | 05 | |
| SC | MEDICARE GROUP | 8683 | 01 |
| Street Address |
1241 WOODLAND AVENUE |
| City | MOUNT PLEASANT |
| State | SC |
| Zip Code | 29464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871542035 | Jon Allen Carmain | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-05-08 |
| 1851506190 | Joshua Nathan Macatol | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2007-05-11 |
| 1760564074 | Christopher K Moses | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-10-19 |
| 1871681445 | Pelican II, LLC | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-10-10 |
| 1811000177 | Charleston Radiologists Pa | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-08-17 |
| 1720191083 | James David Taggart | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-08-17 |
| 1184634628 | William Eugene Phillips II | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-08-08 |
| 1437168226 | Joseph Martin Mullaney | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-08-08 |
| 1558370353 | Michael Charles Garovich | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-08-08 |
| 1043229859 | Steven Lee Vogel | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464-2630 | 2006-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811548241 | Bradley Paul Anuszkiewicz | Chiropractor | 1501 Johnnie Dodds Blvd, Suite C, Mount Pleasant, SC 29464 | 2019-09-26 |
| 1447808696 | Laura Mariah Crouse | Speech-Language Pathologist | Coastal Therapy Services, 1127 Queensborough Blvd, Mt Pleasant, SC 29464 | 2019-08-30 |
| 1912461807 | Independent Optical | Optometrist | 1710 Shoremead Rd, Suite 420, Mount Pleasant, SC 29464 | 2019-01-25 |
| 1417446204 | Michael Adam Sugarman | Clinical Neuropsychologist | 1459 Stuart Engals Blvd Ste 204a, Mt Pleasant, SC 29464 | 2018-05-07 |
| 1578064192 | Ancillary Specialists LLC | Durable Medical Equipment & Medical Supplies | 636 Long Point Road, Unit G, #19, Mount Pleasant, SC 29464 | 2018-02-28 |
| 1346769015 | Christin Solomon Zerega | Counselor | Lowcountry Psychiatry Group, 913 Bowman Rd, #4, Mount Pleasant, SC 29464 | 2017-09-14 |
| 1336660315 | Charleston Neuropsychology LLC | Psychologist | 1459 Stuart Engals Blvd., Suite 204a, Mount Pleasant, SC 29464 | 2017-06-29 |
| 1790219970 | Adam Hudepohl | Family Medicine | 1400 Ben Sawyer Blvd, Mt Pleasant, SC 29464 | 2017-04-14 |
| 1386181204 | Alicia Taylor | Speech-Language Pathologist | 381 Stonewall Ct Apt 6207, Mount Pleasant, SC 29464 | 2017-01-30 |
| 1285181941 | Tara Lynn Mast | Physical Therapist | 1400 Caliper Oak Circle, Apt 316, Mount Pleasant, SC 29464 | 2016-09-09 |
| Find all providers in zip 29464 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962411777 | Ronald Alan Piaskowski | Radiology | 1520 Strathmore Ln, Mount Pleasant, SC 29464-8164 | 2006-08-08 |
| 1396754198 | Raj Ahluwalia | Radiology | 1926 Chatelain Way, Mount Pleasant, SC 29464-3272 | 2006-08-08 |
| 1871681445 | Pelican II, LLC | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-10-10 |
| 1184634628 | William Eugene Phillips II | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-08-08 |
| 1437168226 | Joseph Martin Mullaney | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-08-08 |
| 1558370353 | Michael Charles Garovich | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-08-08 |
| 1043229859 | Steven Lee Vogel | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464-2630 | 2006-08-08 |
| 1548279391 | Mark Leif Greenslit | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-08-07 |
| 1003825878 | Charles Frederick Greer | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-08-07 |
| 1891704664 | Harvey Dan Friedman | Radiology | 1241 Woodland Avenue, Mount Pleasant, SC 29464 | 2006-08-07 |
| Find all providers in MOUNT PLEASANT | ||||
| City | MOUNT PLEASANT |
| Zip Code | 29464 |
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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.