RUSSELL PRENTICE PUCKETT MD
NPI 1225723505
Emergency Medicine in Marietta, GA
About Russell Prentice Puckett Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RUSSELL PRENTICE PUCKETT MD (NPI 1225723505) is an individual emergency medicine provider in Marietta, Georgia, licensed in Georgia (114115) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS and is a graduate of Mercer University School Of Medicine (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Russell Prentice Puckett Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Russell Puckett reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Grovetown, GA 30813
- Reassigned Medicare billing, Georgia enrollment
- 38 clinicians in this Medicare group
Gastonia, NC 28054
- Reassigned Medicare billing, North Carolina enrollment
- 200 clinicians in this Medicare group
Laurinburg, NC 28352
- Reassigned Medicare billing, North Carolina enrollment
- 51 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30060 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MARIETTA, GA 30060
MARIETTA, GA 30060
MARIETTA, GA 30060
MARIETTA, GA 30060
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Russell Puckett's NPI number?
The NPI number for Russell Puckett is 1225723505. It was assigned to this individual provider in the NPPES registry on April 11, 2023.
Where is Russell Puckett located?
Russell Puckett practices at 677 Church St NE, Marietta, GA 30060. The listed phone number is (770) 793-5000.
What is Russell Puckett's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Russell Puckett enrolled in Medicare?
Yes. Russell Puckett is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Russell Puckett's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Russell Puckett reassigns Medicare benefits to 3 organizations: Columbia County Emergency Physicians, LLC (Grovetown, GA), Gastonia Physician Services, PLLC (Gastonia, NC) and North Carolina Emergency Physicians, PLLC (Laurinburg, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Russell Puckett's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Russell Puckett was last updated on July 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Russell Prentice Puckett, MD · NPI 1225723505
Emergency Medicine physician in Marietta, Georgia. Individual provider, active in the CMS NPPES registry since April 11, 2023.
## Identity
- **NPI:** 1225723505 (Entity type: Individual)
- **Enumerated:** April 11, 2023
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 114115 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 677 CHURCH ST NE, Marietta, GA 30060-1101
- **Phone:** (770) 793-5000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Columbia County Emergency Physicians, LLC (NPI 1972461044, Grovetown, GA); Gastonia Physician Services, PLLC (NPI 1316367691, Gastonia, NC); North Carolina Emergency Physicians, PLLC (NPI 1003861386, Laurinburg, NC) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Mercer University School Of Medicine, class of 2023
## Record status
- **NPPES last updated:** July 20, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1225723505) · Data from the CMS NPPES public registry.