Individual provider Active NPI

Lauren Putman, NP

  • Family Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1902542426
Registry record updated May 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
31407 Issued in TN
Practice address
700 W Forest Ave
Jackson, TN 38301-3937
Phone
(731) 541-9490
NPI assigned
May 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 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 31407 TN Primary

Addresses

Primary practice location

700 W Forest Ave
Jackson, TN 38301-3937

Mailing address

700 W Forest Ave
Jackson, TN 38301-3937
Phone (731) 541-9490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20220711000430 TN Practitioner - Nurse Practitioner 1759761570 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
45 Urgent Care PCGroup PAC ID 8628299617, 6 clinicians

Practice addresses (Care Compare)

149 N Star Dr
Jackson, TN 38305-5634
Phone (731) 499-8634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
31407TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Total Wellness Chiropractic, PLLC CurrentSince Sep 1, 2022 Accepting new patients
45 Urgent Care, P.C. CurrentSince Mar 15, 2024 Accepting new patients
Balance Medical and Rehab, PLLC CurrentSince Sep 1, 2022 Accepting new patients
Advanced Rehab and Medical PC Past Accepting new patients

Locations

149 N Star Dr
Jackson, TN 38305
Phone (731) 499-8634

1133 S Main St
Milan, TN 38358
Phone (731) 234-6208

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651968000000",
    "number": "1902542426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W FOREST AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013937",
            "telephone_number": "731-541-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W FOREST AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013937",
            "telephone_number": "731-541-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTMAN",
        "first_name": "LAUREN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-08",
        "last_updated": "2022-05-08",
        "certification_date": "2022-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "31407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.