Active NPI
Colton Wade Putnam, DO
- Family Medicine Physician
- Florence, SC
National Provider Identifier
1154173292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- LL92459
- Practice address
- 555 E. Cheves Street
Florence, SC 29506 - Phone
- (843) 777-2800
- NPI assigned
- Apr 2, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | LL92459 | SC | Primary |
Addresses
Primary practice location
555 E. Cheves Street
Florence, SC 29506
Mailing address
555 E. Cheves Street
Florence, SC 29506
Phone (843) 777-2800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250116000250 | SC | Order and Referring Only - Family Practice | 1456889641 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL92459 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1154173292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 E. CHEVES STREET",
"city": "FLORENCE",
"state": "SC",
"postal_code": "29506",
"telephone_number": "843-777-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 E. CHEVES STREET",
"city": "FLORENCE",
"state": "SC",
"postal_code": "29506",
"telephone_number": "843-777-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTNAM",
"first_name": "COLTON",
"middle_name": "WADE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-02",
"last_updated": "2024-06-26",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "LL92459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, SC
- Lauren Agnes Punter, M.D.
- Pure Life Chiropractic, P.C.
- Chiquita Jacquelle Purvis
- Colby Scott Purvis, DO
- Jackson Cohen Purvis
- Somer Pye, PHARMD
- QHG of South Carolina Inc (Carolinas Hospital System Transitional Care Unit)
- QHG of South Carolina Inc (Carolina Hospital System-Florence)
- QHG of South Carolina Inc (Lab Carolinas)
- QHG of South Carolina Inc (Carolinas Hospital System)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.