Dr Terry Lee Puckett, MD, MPH is a medicare enrolled "Preventive Medicine - Aerospace Medicine" physician in Abingdon, Virginia. His current practice location is
24530 Falcon Place Blvd Ste 100, Abingdon, Virginia. You can reach out to his office (for appointments etc.) via phone at
(276) 619-0075.
Dr Terry Lee Puckett is licensed to practice in Virginia (license number 0101241208) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1376510222.
Physician's Profile
| Full Name | Dr Terry Lee Puckett |
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| Gender | Male |
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| Speciality | Preventive Medicine - Aerospace Medicine |
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| Location | 24530 Falcon Place Blvd Ste 100, Abingdon, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1376510222
- Provider Enumeration Date: 02/28/2006
- Last Update Date: 06/05/2018
Medicare PECOS Information:
- PECOS PAC ID: 3577667831
- Enrollment ID: I20070327000518
Medical Identifiers
Medical identifiers for Dr Terry Lee Puckett such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1376510222 | NPI | - | NPPES |
| 1376510222 | Medicaid | VA | |
| Q000141 | Medicaid | TN | |
| P01599940 | Other | VA | RR MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2083A0100X | Preventive Medicine - Aerospace Medicine | MD 18289 (Tennessee) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | MD 18289 (Tennessee) | Secondary |
| 2083A0100X | Preventive Medicine - Aerospace Medicine | 0101241208 (Virginia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Terry Lee Puckett allows following entities to bill medicare on his behalf.
| Entity Name | Blue Ridge Medical Management Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1144380833
PECOS PAC ID: 9739099441
Enrollment ID: O20031204000996 |
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| Entity Name | Wellmont Medical Associates Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1780986257
PECOS PAC ID: 8123291739
Enrollment ID: O20111026000909 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Terry Lee Puckett is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Terry Lee Puckett, MD, MPH
603 Campus Dr, Suite 100,
Abingdon, VA 24210-9700
Ph: (276) 739-8010 | Dr Terry Lee Puckett, MD, MPH
24530 Falcon Place Blvd Ste 100,
Abingdon, VA 24211-7665
Ph: (276) 619-0075 |
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