Nicolle Jeanette Putnam, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164.005326 Issued in IL

Practice address

2001 5TH St
Suite 51
Silvis, IL 61282-2903

Phone

(309) 792-1507

Fax

(309) 792-1518

NPI assigned

Nov 3, 2010

Last updated

Nov 3, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288742400000",
    "number": "1023319365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 E 7TH ST",
            "address_2": "#208",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528035513",
            "telephone_number": "515-720-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 5TH ST",
            "address_2": "SUITE 51",
            "city": "SILVIS",
            "state": "IL",
            "postal_code": "612822903",
            "telephone_number": "309-792-1507",
            "fax_number": "309-792-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTNAM",
        "first_name": "NICOLLE",
        "middle_name": "JEANETTE",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-03",
        "last_updated": "2010-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.005326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew F Philip, M.D.
• Carrie Piazza, PTA
• Alexander David Pinc, M.D.
• Shannon E Pirmann, MA, ATC, LAT
• Prime Transit LLC
• Quad Cities Kidney Center Silvis, LLC
• Maher Rabie, PHARMD
• Olivia Ramirez
• Goyanka Ranganathan, MD
• Rock Valley Physical Therapy Center

• Registered Dietitian in Silvis, IL
• Providers in Silvis, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.