PUTNAM COMMUNITY MEDICAL CENTER LLC (NPI# 1760599286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760599286 |
| Entity Type | Organization |
| Organization Name | PUTNAM COMMUNITY MEDICAL CENTER LLC |
| Other Organization Name | PUTNAM COMMUNITY MEDICAL CENTER |
| Practice Address |
611 Zeagler Dr Palatka FL 32177-3810 |
| Mailing Address |
330 Seven Springs Way Brentwood TN 37027-4536 |
| Practice Telephone | 3863285711 |
| Practice Fax Number | 3863258178 |
| Mailing Telephone | 6159207000 |
| Mailing Fax Number | 6159208913 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2014-04-09 |
| Authorized Official Name | DONALD J. BIVACCA (PRESIDENT) |
| Authorized Official Telephone | 6159207000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
4350 | FL | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 011351400 | 05 |
| Other Name | Type Code |
|---|---|
| Putnam Community Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295154185 | Putnam Community Medical Center LLC | Pharmacy | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2014-04-08 |
| 1558417295 | Putnam Community Medical Center LLC | Skilled Nursing Facility | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2007-01-26 |
| 1801942545 | Putnam Community Medical Center LLC | Emergency Medicine | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2007-01-26 |
| Street Address |
611 ZEAGLER DR |
| City | PALATKA |
| State | FL |
| Zip Code | 32177-3810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447244058 | Jennifer Lee Hart | Nurse Anesthetist, Certified Registered | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2005-09-09 |
| 1487120812 | Michele Cole | Registered Nurse | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2018-10-24 |
| 1619485760 | Brandon Dewayne Morgan | Student in an Organized Health Care Education/Training Program | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2018-01-10 |
| 1174038970 | Andrew Brian Kirkland | Physician Assistant | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2017-12-04 |
| 1295274546 | Jennifer Dye Standridge | Skilled Nursing Facility | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2017-02-20 |
| 1003352782 | Lindsey Fletcher | Nurse Practitioner | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2017-01-18 |
| 1437694056 | Brandi Rae Curtis | Nurse Practitioner | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2017-01-05 |
| 1609228196 | Vincent Demond Wright | Nurse Anesthetist, Certified Registered | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2016-07-07 |
| 1710331665 | Tamara Baxter | Nurse Practitioner | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2016-04-18 |
| 1740676220 | Putnam Community Medical Center of North Florida, LLC | Medicare Defined Swing Bed Unit | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2015-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174124176 | Charlie Douglas | Pharmacist | 1024 South State Road 19, Pharmacy, Palatka, FL 32177 | 2020-11-05 |
| 1275090359 | Carol M Kazounis | Dietitian, Registered | 2801 Kennedy Strett, Palatka, FL 32177 | 2019-02-26 |
| 1447744768 | Pulido Internal Medicine | Nurse Practitioner | 700 Zeagler Drive, Suite 1, Palatka, FL 32177 | 2018-06-20 |
| 1063922656 | Ronald Michael Wendt | Nurse Practitioner | 3703 Crill Ave, Palatka, FL 32177 | 2017-10-09 |
| 1043560212 | Leslie Ann Lewis | Massage Therapist | 325 Poinsetta Ave, Palatka, FL 32177 | 2012-09-14 |
| 1285984963 | Walgreens | Pharmacy | 719 South State Road 19, Palatka, FL 32177 | 2012-09-11 |
| 1841549235 | Audrey M Russell | Pharmacy Technician | 719 Hwy 19 South, Palatka, FL 32177 | 2012-08-31 |
| 1194023838 | Sherry D. Michael | Licensed Practical Nurse | 330 Kay Larkin Dr., Palatka, FL 32177 | 2011-03-04 |
| 1083846364 | Patricia Kowalchuk | Occupational Therapy Assistant | 6050 St.johns Ave., Suite A, Palatka, FL 32177 | 2009-08-20 |
| 1609015320 | Robin Calhoun | Occupational Therapist | 611 Zeagler Dr., Palatka, FL 32177 | 2009-02-19 |
| Find all providers in zip 32177 | ||||
| Taxonomy Code | 282NR1301X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Rural |
| Definition to come... |
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| 1972985489 | Christine Truschka Larsen | General Acute Care Hospital | 1835 Sw 34th Ct, Ocala, FL 34474-2836 | 2015-06-19 |
| 1215353933 | Broward Health | General Acute Care Hospital | 1608 Se 3rd Avenue, Fort Lauderdale, FL 33316 | 2014-03-06 |
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| 1467534917 | H C Healthcare Inc | General Acute Care Hospital | 506 Nw 4th Street, Jasper, FL 32052-6603 | 2006-10-20 |
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| 1710984299 | Healthmark of Walton Inc | General Acute Care Hospital | 4413 Us Highway 331 S, Defuniak Springs, FL 32435-6307 | 2005-06-30 |
| 1295274983 | Miami Va Healthcare System | General Acute Care Hospital | 1201 Nw 16th St, Miami, FL 33125-1624 | 2017-02-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.