JODI LYN PUTNAM (FNP-C) – Family Nurse Practitioner, NPI 1558109504

JODI LYN PUTNAM (FNP-C) is a healthcare provider. based in Spanish fork, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 7992533-4405 (UT). The NPI Number for JODI LYN PUTNAM (FNP-C) is 1558109504

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
JODI LYN PUTNAM (FNP-C)
NPI
1558109504
Phone
(385) 518-0403
Address
1416 NORTH MAIN ST
Enumeration Date
15 July 2024
Last Update Date
28 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8015618398
Graduation Year
2024 (2 years ago)
PAC ID
9830636836
Group Practice PAC ID
2264973437
Professional Enrollment ID
I20240808001760
Address ID
UT840953946SO406XXPKWY501
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness75
Years active:1State licenses:1Digital endpointsOther names

2,672 NURSE PRACTITIONER in UT

Provider Addresses for JODI LYN PUTNAM (FNP-C)

  • 1416 NORTH MAIN ST

    STE 1B

    SPANISH FORK, UT 84660

    Phone: (385) 518-0403

    Fax: (385) 518-0466

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-08

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240808001760INurse PractitionerUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84660)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2264973437View full group profile
NameSpecialtyState
Physician AssistantWA
Nurse PractitionerUT
Physician AssistantUT
Nurse PractitionerUT
Family PracticeUT
Nurse PractitionerUT
Nurse PractitionerUT
Family PracticeNV

Reviews

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Frequently asked questions

What is the 10-digit NPI for JODI LYN PUTNAM (FNP-C)?
JODI LYN PUTNAM (FNP-C) — NPI 1558109504 — is the standard way to identify this listing.
Can I rely on JODI LYN PUTNAM (FNP-C) being an active provider?
As of the registry snapshot, JODI LYN PUTNAM (FNP-C) is marked active.
What is JODI LYN PUTNAM (FNP-C)'s specialty?
The listing groups JODI LYN PUTNAM (FNP-C) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What address line appears for JODI LYN PUTNAM (FNP-C)?
JODI LYN PUTNAM (FNP-C)'s geographic hint is Spanish Fork, Utah in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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