Individual provider Active NPI

Zachary Dylan Putman, CRNA

  • Certified Registered Nurse Anesthetist
  • Huntsville, AL
National Provider Identifier
1578036141
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
125110 Issued in AL
Practice address
101 Sivley Rd SW
Huntsville, AL 35801-4421
Phone
(256) 265-1000
NPI assigned
Jan 7, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 125110 AL Primary

Addresses

Primary practice location

101 Sivley Rd SW
Huntsville, AL 35801-4421

Mailing address

2302 Willow Beach Rd Apt C5
Guntersville, AL 35976-2236
Phone (256) 603-1708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190513001967 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971846098 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cullman Pain and Wellness LLCGroup PAC ID 1052724713, 14 clinicians
Marshall Medical Center SouthGroup PAC ID 0648534495, 43 clinicians

Practice addresses (Care Compare)

1848 Parkland Dr NE
Cullman, AL 35058-6100
Phone (256) 737-4000

2505 US Hwy 431
Boaz, AL 35957-5908
Phone (256) 593-8310

Hospital & facility affiliations

  • Marshall Medical Centers Hospital, Boaz, AL, CCN 010005

Merit-based Incentive Payment System (MIPS)

Final score
83.19 of 100Reported as group
Quality
58.18
Improvement activities
40
Cost
76.12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
125110ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center South Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2019 Accepting new patients
Huntsville Hospital Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Feb 19, 2019 Accepting new patients
Cullman Pain and Wellness LLC CurrentSince Jun 1, 2022 Accepting new patients
Cullman Pain and Wellness LLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

2505 US Highway 431
Boaz, AL 35957
Phone (256) 506-0061

1848 Parkland Dr NE
Cullman, AL 35058
Phone (256) 737-4100

1701 Main Ave SW
Ste E
Cullman, AL 35055
Phone (256) 531-9213

8000 AL Highway 69
Guntersville, AL 35976
Phone (256) 571-8000

245 Governors Dr SE
Huntsville, AL 35801
Phone (256) 265-7673

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

201 Governors Dr SW
Huntsville, AL 35801
Phone (256) 265-6851

8375 Highway 72 W
Madison, AL 35758
Phone (256) 265-2012

Organizations & group practices 4

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.

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": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1578036141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 WILLOW BEACH RD APT C5",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762236",
            "telephone_number": "256-603-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SIVLEY RD SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014421",
            "telephone_number": "256-265-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTMAN",
        "first_name": "ZACHARY",
        "middle_name": "DYLAN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "125110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.