Individual provider Active NPI

Lisa Ellen Putney, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Bemidji, MN
National Provider Identifier
1477645083
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
41406 Issued in MN
Practice address
403 America Ave NW
Bemidji, MN 56601-3122
Phone
(218) 444-8727
Fax
(218) 444-8546
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 41406 MN Primary
Family Medicine Physician 207Q00000X 41406 MN

Addresses

Primary practice location

403 America Ave NW
Bemidji, MN 56601-3122

Mailing address

1005 Lake Blvd NE
Bemidji, MN 56601-3921
Phone (218) 751-2458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bemidji Health and Wellness Center, P.C. Past Accepting new patients

Organizations & group practices 1

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1477645083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 LAKE BLVD NE",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013921",
            "telephone_number": "218-751-2458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 AMERICA AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013122",
            "telephone_number": "218-444-8727",
            "fax_number": "218-444-8546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTNEY",
        "first_name": "LISA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MN",
            "license": "41406",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "41406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.