Individual provider Active NPI

Dawn Greene-Putulin, ARNP

  • Family Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1578147104
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11013298 Issued in FL
Practice address
1218 Court St
Clearwater, FL 33756-5809
Phone
(727) 447-3041
NPI assigned
May 10, 2021
Last updated
Jan 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11013298 FL Primary

Addresses

Primary practice location

1218 Court St
Clearwater, FL 33756-5809

Mailing address

2985 Drew St
Clearwater, FL 33759-3012
Phone (727) 820-8200

Other practice location 1

2985 Drew St
Clearwater, FL 33759-3012
Phone (727) 820-8200

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11013298FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clearwater Free Clinic, Inc. CurrentSince Mar 27, 2022 Accepting new patients

Locations

1218 Court St
Clearwater, FL 33756
Phone (727) 447-3041

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1578147104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2985 DREW ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-820-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 COURT ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337565809",
            "telephone_number": "727-447-3041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2985 Drew St",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337593012",
            "country_code": "US",
            "telephone_number": "727-820-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENE-PUTULIN",
        "first_name": "DAWN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11013298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.