Individual provider Active NPI

Chad W Putman, MD

  • Otolaryngology Physician
  • Rogers, AR
National Provider Identifier
1184745150
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
E-9602 Issued in AR
Practice address
5204 W Redbud St
Rogers, AR 72758-8936
Phone
(479) 636-0110
Fax
(479) 636-0491
NPI assigned
Apr 3, 2007
Last updated
Jul 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X E-9602 AR Primary

Addresses

Primary practice location

5204 W Redbud St
Rogers, AR 72758-8936

Mailing address

5204 W Redbud St
Rogers, AR 72758-8936
Phone (479) 636-0110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160728000570 AR Practitioner - Otolaryngology 3779635479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Medical Branch at Galveston, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5204 W Redbud St
Nwa Ear Nose and Throat
Rogers, AR 72758-8936
Phone (479) 636-0110

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-9602ARMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities Otolaryngology CurrentSince Jul 18, 2016 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jul 18, 2016 Accepting new patients
Mercy Health Northwest Arkansas Communities Past Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

5204 W Redbud St
Rogers, AR 72758
Phone (479) 636-0110

Interoperability endpoints

  • Direct secure messaging: chadputman@entst.allscriptsdirect.net
  • Direct secure messaging: cputman759841@directc.mercy.net

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1184745150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5204 W REDBUD ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588936",
            "telephone_number": "479-636-0110",
            "fax_number": "479-636-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5204 W REDBUD ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588936",
            "telephone_number": "479-636-0110",
            "fax_number": "479-636-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTMAN",
        "first_name": "CHAD",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AR",
            "license": "E-9602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.