Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kodi J Puckett, PA

Individual provider Medical Physician Assistant · NPI 1184004475

Kodi J Puckett, PA is a Physician Assistant in Va Beach, Virginia. Graduated from Eastern Virginia Medical School in 2015, 11 years ago. Accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
11
Trained at
Eastern Virginia Medical School
Licensed in
VA
In the registry since
2015
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4092 Foxwood Dr Ste 100
Va Beach, VA 23462-5225
Phone: (757) 686-3508
Fax: (757) 686-0541
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X (VA)

Record details

NPI number1184004475
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 2, 2015
Last updated in NPPESSeptember 4, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolEASTERN VIRGINIA MEDICAL SCHOOL
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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