Shawn Robert Putnam, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

257127 Issued in MA

Practice address

440 New Britain Ave
Plainville, CT 06062-2036

Phone

(860) 793-0500

Fax

(860) 793-1116

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Comprehensive Pain Management of Central Connecticut, LLC

  • Interventional Pain Medicine Physician
  • Plainville, CT
  • NPI 1770776023
  Medicare reassignment NPD

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1033150719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 ASYLUM AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172602",
            "telephone_number": "860-793-0500",
            "fax_number": "860-793-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 NEW BRITAIN AVE",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622036",
            "telephone_number": "860-793-0500",
            "fax_number": "860-793-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTNAM",
        "first_name": "SHAWN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "257127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET PROVIDER #",
            "identifier": "3V3059",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1033150719",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia V.F. Price
• Primary Care Physicians of Central CT
• Krista Marie Prince, MSW
• Victoria Marie Pryputniewicz, PA
• Davina Przygoda
• Philip James Putney, CRNA
• Rita Lisa Quiles Ferrabelo
• Sarah Nicole Quinn
• Carmelita Quinones
• Saleha A. Qureshi, MA MS

• Family Nurse Practitioner in Plainville, CT
• Providers in Plainville, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.