DR. TERRY LEE PUCKETT (NPI# 1376510222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376510222 |
| Entity Type | Individual |
| Full Name | DR. TERRY LEE PUCKETT |
| Credential | M.D., M.P.H. |
| Practice Address |
24530 Falcon Place Blvd Ste 100 Abingdon VA 24211-7665 |
| Mailing Address |
603 Campus Dr Suite 100 Abingdon VA 24210-9700 |
| Practice Telephone | 2766190075 |
| Practice Fax Number | 2766190077 |
| Mailing Telephone | 2767398010 |
| Mailing Fax Number | 2766281410 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2018-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083A0100X |
Preventive Medicine Specialization: Aerospace Medicine |
0101241208 | VA | Allopathic & Osteopathic Physicians |
| N | 2083A0100X |
Preventive Medicine Specialization: Aerospace Medicine |
MD 18289 | TN | Allopathic & Osteopathic Physicians |
| N | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
MD 18289 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q000141 | 05 | |
| VA | 1376510222 | 05 | |
| VA | RR MEDICARE | P01599940 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 111 W Stone Dr Ste 110, Kingsport, TN 376606027 | 4232243701 | 4232243709 |
| 378 Marketplace Dr Ste 5, Johnson City, TN 376042361 | 4232820751 | 4232821577 |
| 603 Campus Dr Ste 100, Abingdon, VA 242109700 | 2767398010 | 2766281410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315178 | Terry Gay Puckett | Specialist/Technologist | 136 Paloma Dr, San Antonio, TX 78212-1771 | 2019-09-16 |
| 1336257336 | Terry E Puckett | Nurse Anesthetist, Certified Registered | 145 Newcomb Ave, Mount Vernon, KY 40456-2728 | 2006-08-29 |
| Street Address |
24530 FALCON PLACE BLVD STE 100 |
| City | ABINGDON |
| State | VA |
| Zip Code | 24211-7665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548247208 | Mary Garretson Mcclain | Nurse Practitioner | 24530 Falcon Place Blvd Ste 100, Abingdon, VA 24211-7665 | 2005-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386087245 | Abingdon Apothecary, Inc. | Pharmacy | 26100 Lee Highway, Abingdon, VA 24211 | 2013-04-10 |
| 1255671152 | Mac's Medical Equipment and Supplies, Inc. | Durable Medical Equipment & Medical Supplies | 26102 Lee Highway, Abingdon, VA 24211 | 2013-03-01 |
| 1316290737 | Falcon Pharmacy | Pharmacy | 795 Cummings Street, Abingdon, VA 24211 | 2012-10-23 |
| 1407027402 | Carla M. Keene, D.d.s. | Dentist | 15189 Porterfield Highway, Abingdon, VA 24211 | 2008-03-18 |
| 1215001045 | Bernard A Tisdale Md PC | Radiology | 26079 Lee Highway, Abingdon, VA 24211 | 2006-11-20 |
| 1982670048 | Jeffrey Allen Mccraw | Anesthesiology | 351 North Court St, Abingdon, VA 24211 | 2006-02-27 |
| 1356320881 | Joseph A Brown | Internal Medicine | 16000 Johnston Memorial Drive, Suite 304, Abingdon, VA 24211 | 2006-01-12 |
| 1922667435 | Saman Saeed | Student in an Organized Health Care Education/Training Program | 16000 Johnston Memorial Drive, Abingdon, VA 24211 | 2019-06-08 |
| 1487140562 | Joshua Aaron Hess | Nurse Practitioner | 16000 Johnston Memorial Dr, Abingdon, VA 24211 | 2018-07-02 |
| 1073005989 | Carl Thurman Harrison Jr. | Nurse Practitioner | 16000 Johnston Memorial Dr, Abingdon, VA 24211 | 2018-06-06 |
| Find all providers in zip 24211 | ||||
| Taxonomy Code | 2083A0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Aerospace Medicine |
| Aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952925307 | Susan Hanley Tilton | Preventive Medicine | 1855 Stratford Park Pl Apt 413, Reston, VA 20190-3355 | 2020-06-02 |
| 1336605641 | Arnauld T Nicogossian | Preventive Medicine | 9215 Bayard Pl, Fairfax, VA 22032-2103 | 2019-02-12 |
| 1477079754 | Richard Stuart Williams | Preventive Medicine | 81 Flight Line Dr, Fredericksburg, VA 22405-1437 | 2017-08-17 |
| 1861741662 | Leroy Patrick Gross | Preventive Medicine | 2 Eaton St, Suite 908, Hampton, VA 23669-4054 | 2012-09-07 |
| 1275839573 | Russell Barry Rayman | Preventive Medicine | 8710 Linton Lane, Alexandria, VA 22308 | 2011-02-03 |
| 1023336799 | Arne Hasselquist | Preventive Medicine | 100 State Park Dr, Hampton, VA 23664-1965 | 2010-05-05 |
| 1659696078 | Huberto Isaac Ramos | Preventive Medicine | 2136 Hickory Forest Dr, Chesapeake, VA 23322-1758 | 2010-03-29 |
| 1649407222 | Peter F Demitry | Preventive Medicine | 3700 Drake Ln, Haymarket, VA 20169-2477 | 2009-06-22 |
| 1346312501 | Edward H Chin | Preventive Medicine | 25755 Tullow Pl, Chantilly, VA 20152-2572 | 2006-11-14 |
| 1407940729 | William Patrick Butler | Preventive Medicine | 732 Okuma Dr, Chester, VA 23836-5711 | 2006-10-03 |
| Find all providers with the same taxonomy | ||||
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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.