Helen Minnetta Putnam, OTRL, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

005162 Issued in GA

Practice address

300 E. Hospital Road
Eisenhower Army Medical Center
Fort Gordon, GA 30905-5650

Phone

(706) 787-2535

Fax

(706) 787-1327

NPI assigned

Dec 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1619032349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E. HOSPITAL ROAD",
            "address_2": "EISENHOWER ARMY MEDICAL CENTER",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-2535",
            "fax_number": "706-787-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E. HOSPITAL ROAD",
            "address_2": "EISENHOWER ARMY MEDICAL CENTER",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-2535",
            "fax_number": "706-787-1327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTNAM",
        "first_name": "HELEN",
        "middle_name": "MINNETTA",
        "credential": "OTRL, PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT001332",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000692601B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth R Powers, RDH
• Hosamane S Prabhakara, MD
• Christopher Shane Pritchard
• Dan Melbourne Prucha, DDS
• Quinnon Ralph Purvis, M.D.
• Jacques R Pye, MD
• Kristen Leigh Qadadah, RN
• Sandra L Quinones
• Amanda Q Rabun, RN
• Bric McCutcheon Rahimi, M.D.

• Physician Assistant in Fort Gordon, GA
• Providers in Fort Gordon, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.