Active NPI
Bernadette Putman, CCC-SLP
- Speech-Language Pathologist
- Roseville, MN
National Provider Identifier
1891955779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8289
- Practice address
- 1000 Lovell Ave W
Roseville, MN 55113-4419 - Phone
- (651) 484-3378
- NPI assigned
- Jun 13, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 8289 | MN | Primary |
Addresses
Primary practice location
1000 Lovell Ave W
Roseville, MN 55113-4419
Mailing address
1000 Lovell Ave W
Roseville, MN 55113-4419
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8289 | MN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213315200000",
"number": "1891955779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 LOVELL AVE W",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551134419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 LOVELL AVE W",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551134419",
"telephone_number": "651-484-3378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTMAN",
"first_name": "BERNADETTE",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-13",
"last_updated": "2008-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MN",
"license": "8289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.