Kristy Jo Putnam

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

19246 Three Oaks Rd
Three Oaks, MI 49128-9511

Phone

(269) 612-7222

NPI assigned

Sep 27, 2020

Last updated

Sep 27, 2020By 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 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Lifecraft LLC

  • Athletic Trainer
  • Three Oaks, MI
  • NPI 1649887373

  Health Educator

  NPD Authorized official
• Lifecraft LLC

  • Recreation Therapist
  • La Porte, IN
  • NPI 1407420573

  Health Educator

  NPD Authorized official

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

{
    "created_epoch": "1601164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601164800000",
    "number": "1639786361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19246 THREE OAKS RD",
            "city": "THREE OAKS",
            "state": "MI",
            "postal_code": "491289511",
            "telephone_number": "269-612-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19246 THREE OAKS RD",
            "city": "THREE OAKS",
            "state": "MI",
            "postal_code": "491289511",
            "telephone_number": "269-612-7222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3810 Madison St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490082621",
            "country_code": "US",
            "telephone_number": "269-612-7222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1004 Weller Ave",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463502934",
            "country_code": "US",
            "telephone_number": "269-612-7222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUTNAM",
        "first_name": "KRISTY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-27",
        "last_updated": "2020-09-27",
        "certification_date": "2020-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "226000000X",
            "taxonomy_group": "",
            "desc": "Recreational Therapist Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Humble Haven Homestead
• Lifecraft LLC
• Debra Zakrzewski Mannia, DDS
• Paul Mannia, D.D.S.
• Tiffany Peters, LMSW
• Kamaliah Scally, RBT
• Three Oaks Emergency Vehicle Association
• Three Shores Health Care
• Alicia Young, LPTA

• Athletic Trainer in Three Oaks, MI
• Providers in Three Oaks, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2020; 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.