Putnam Family Care, Inc.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

54QP00053 Issued in FL

Legal business name

PUTNAM FAMILY CARE, INC.

Practice address

6101 Crill Ave
Palatka, FL 32177-3875

Phone

(386) 326-1225

NPI assigned

Jul 29, 2006

Organization subpart

No

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

Authorized official

Name

Jerry Jacobson, M.D.

Title

VP

Phone

(386) 326-1225

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derek Bohn, M.D.

  • General Practice Physician
  • Palatka, FL
  • NPI 1992719207
  Medicare reassignment Care Compare group NPD
• Jerome R Jacobson, M.D.

  • General Practice Physician
  • Palatka, FL
  • NPI 1770590168
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373932800000",
    "number": "1205840519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773875",
            "telephone_number": "386-326-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTNAM FAMILY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2013-07-16",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "386-326-1225",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "54QP00053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267777600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Putnam County Public School District
• Putnam County Public School District
• Putnam Diagnostic, Inc.
• Putnam E N T PA
• Putnam Emergency Group LLC
• Putnam Heart Center PA
• Putnam Imaging Center, LLC
• Putnam Neurology Group, Inc.
• Putnam Obstetrics and Gynecology PA
• Putnam Physician Practices (Putnam Neurology Associates)

• Urgent Care Clinic/Center in Palatka, FL
• Providers in Palatka, FL by specialty
• Urgent Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.