Autumn Putnam

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1215 Fulton St E
Grand Rapids, MI 49503-3849

Phone

(616) 742-0351

Fax

(616) 742-0370

NPI assigned

May 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of OttawaGroup PAC ID 0042118036, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• County of Ottawa

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holland, MI
  • NPI 1619932381
  Medicare reassignment Care Compare group NPD
• County of Ottawa

  • Non-Surgical Family Planning Clinic/Center
  • Holland, MI
  • NPI 1679653422
  NPD
• Ottawa County CMH

  • Community/Behavioral Health Agency
  • Grand Haven, MI
  • NPI 1346329570
  NPD (past)

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1568084226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 FULTON ST E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033849",
            "telephone_number": "616-742-0351",
            "fax_number": "616-742-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 FULTON ST E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033849",
            "telephone_number": "616-742-0351",
            "fax_number": "616-742-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTNAM",
        "first_name": "AUTUMN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6801106880",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SAUSC.ORG",
            "affiliation": "N",
            "address_1": "1215 Fulton St E",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495033849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katarzyna Maria Purzycka, DO
• Corrie Puscas
• John Pusta, CRNA
• Caroline M Pustover, PT
• Maci Putman
• Alessandra Puzio
• Courtney Ann Pyle
• Elizabeth A Pyle
• Justin Pyle
• Mary Colman Pyle, MS,ED., LLMSW

• Addiction (Substance Use Disorder) Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.
• 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.