Individual provider Active NPI

Stefanie Marie Putnam, M.D.

  • Adolescent Medicine (Internal Medicine) Physician
  • Simpsonville, SC
National Provider Identifier
1396845103
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
29131 Issued in SC
Practice address
727 SE Main St
Suite 300
Simpsonville, SC 29681-3247
Phone
(864) 454-6440
Fax
(864) 454-6445
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 29131 SC Primary

Addresses

Primary practice location

727 SE Main St
Suite 300
Simpsonville, SC 29681-3247

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6044

Other practice location 1

101 E Wood St
Spartanburg, SC 29303-3040
Phone (864) 560-6287

Other identifiers 2

IdentifierTypeStateIssuer
291311MedicaidSC
SCL4453365OtherSCMEDICARE PIN

Other names 1

  • Stefanie F. Adair Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sputnam233414@direct-srhs.et0939.epichosted.com Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101210000370 SC Practitioner - Pediatric Medicine 6800083262 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29131SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Health System Current Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Oct 1, 2021 Accepting new patients
Greenville Health System CurrentSince Sep 7, 2010 Accepting new patients
Spartanburg Medical Center CurrentSince Oct 1, 2021 Accepting new patients
Spartanburg Medical Center Past Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1396845103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 SE MAIN ST",
            "address_2": "SUITE 300",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813247",
            "telephone_number": "864-454-6440",
            "fax_number": "864-454-6445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Wood St",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293033040",
            "country_code": "US",
            "telephone_number": "864-560-6287",
            "fax_number": "864-560-7091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUTNAM",
        "first_name": "STEFANIE",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "SC",
            "license": "29131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291311",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCL4453365",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sputnam233414@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sputnam233414@direct-srhs.et0939.epichosted.com",
            "address_1": "101 E Wood St",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293033040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "ADAIR",
            "middle_name": "F.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Simpsonville, SC

Sources for this page

Verify at the official NPI Registry.