Theresa Darlene Putman, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-074182 Issued in AL

Practice address

108 4TH Ave SW Ste a
Reform, AL 35481-8018

Phone

(205) 375-6251

NPI assigned

Jan 18, 2013

Last updated

Nov 19, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Alabama School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jlbmd Consulting PCGroup PAC ID 6901235969, 2 clinicians

Tuskaloosa Internal Medicine LLCGroup PAC ID 2264451137, 9 clinicians

Pickens County Primary Care, PCGroup PAC ID 1658597307, shared by 4 NPIs, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DCH Regional Medical Center Hospital, Tuscaloosa, AL, CCN 010092

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

• Tuskaloosa Internal Medicine LLC

  • Internal Medicine Physician
  • Tuscaloosa, AL
  • NPI 1235221847
  Medicare reassignment Care Compare group NPD
• Jlbmd Consulting, PC

  • Family Medicine Physician
  • Reform, AL
  • NPI 1003449869
  Medicare reassignment Care Compare group
• Pickens County Primary Care PC

  • Family Medicine Physician
  • Reform, AL
  • NPI 1629491451
  Medicare reassignment NPD
• Pickens County Primary Care, P.C

  • Rural Health Clinic/Center
  • Gordo, AL
  • NPI 1063988806
  Medicare reassignment NPD
• Pickens County Primary Care, P.C

  • Rural Health Clinic/Center
  • Reform, AL
  • NPI 1508332446
  NPD
• Pickens County Primary Care, PC

  • Rural Health Clinic/Center
  • Gordo, AL
  • NPI 1295421667
  NPD
• Internal Medicine Associates of Tuscaloosa, P.C.

  dba Novus TMS Imat

  • Neurology Physician
  • Tuscaloosa, AL
  • NPI 1598414880
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The DCH Health Care Authority

  dba DCH Health & Wellness Clinic

  • Clinic/Center
  • Tuscaloosa, AL
  • NPI 1306613211

  Hospital

  Care Compare affiliation
• The DCH Health Care Authority

  dba DCH Outpatient Services

  • Clinic/Center
  • Tuscaloosa, AL
  • NPI 1780927681

  Hospital

  Care Compare affiliation
• The DCH Healthcare Authority

  dba DCH Regional Medical Center

  • General Acute Care Hospital
  • Tuscaloosa, AL
  • NPI 1841394418
  Care Compare affiliation

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

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1609114198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 4TH AVE SW STE A",
            "city": "REFORM",
            "state": "AL",
            "postal_code": "354818018",
            "telephone_number": "205-375-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 4TH AVE SW STE A",
            "city": "REFORM",
            "state": "AL",
            "postal_code": "354818018",
            "telephone_number": "205-375-6251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Ruby Tyler Pkwy",
            "address_purpose": "LOCATION",
            "city": "Tuscaloosa",
            "state": "AL",
            "postal_code": "354042959",
            "country_code": "US",
            "telephone_number": "205-759-2582",
            "fax_number": "205-759-2985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUTMAN",
        "first_name": "THERESA",
        "middle_name": "DARLENE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-18",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-074182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pickens County Medical Center, Inc (Reform Primary Care Clinic)
• Pickens County Medical Center, Inc (Reform Primary Care)
• Pickens County Primary Care PC
• Pickens County Primary Care, P.C
• Pickens County Primary Care, PC
• Reform Medical Clinic (Harry L Richardson)
• Reform Pharmacy Inc
• Reform Rural Health Center PC
• Harry Lee Richardson Jr., MD
• Brenda Sue Robertson

• Nurse Practitioner in Reform, AL
• Providers in Reform, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.