Individual provider Active NPI

Cheryl Lea Butler, NP

  • Family Nurse Practitioner
  • Beaver Dam, WI
National Provider Identifier
1073010229
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8342-33 Issued in WI
Practice address
120 Park Ave Ste 1
Beaver Dam, WI 53916-2132
Phone
(920) 885-5225
Fax
(920) 356-6419
NPI assigned
Apr 12, 2018
Last updated
Jan 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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 8342-33 WI Primary

Addresses

Primary practice location

120 Park Ave Ste 1
Beaver Dam, WI 53916-2132

Mailing address

120 Park Ave Ste 1
Beaver Dam, WI 53916-2132
Phone (920) 885-5225

Other practice location 1

123 Hospital Dr Ste 2002
Watertown, WI 53098-3320
Phone (920) 885-5225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20180606002220 WI Practitioner - Nurse Practitioner 6608131008 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Face and Skin LLCGroup PAC ID 0244428340, 4 clinicians

Practice addresses (Care Compare)

120 Park Ave
Suite 1
Beaver Dam, WI 53916-2132
Phone (920) 885-5225

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Apr 17, 2018 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Apr 17, 2018 Accepting new patients
Face and Skin LLC CurrentSince Jan 1, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc Current Accepting new patients

Locations

120 Park Ave
Ste 1
Beaver Dam, WI 53916
Phone (920) 356-6416

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

707 S University Ave
Beaver Dam, WI 53916
Phone (920) 887-4006

1580 W James St
Columbus, WI 53925
Phone (920) 345-1306

610 Washington St
Horicon, WI 53032
Phone (920) 485-4341

123 Hospital Dr
Ste 2002
Watertown, WI 53098
Phone (920) 261-1334

123 Hospital Dr
Ste 2003
Watertown, WI 53098
Phone (920) 245-5741

180 Gateway Dr
Waupun, WI 53963
Phone (920) 345-1306

Interoperability endpoints

  • Direct secure messaging: cheryl.butler@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1073010229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PARK AVE STE 1",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162132",
            "telephone_number": "920-885-5225",
            "fax_number": "920-356-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PARK AVE STE 1",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162132",
            "telephone_number": "920-885-5225",
            "fax_number": "920-356-6419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Hospital Dr Ste 2002",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "WI",
            "postal_code": "530983320",
            "country_code": "US",
            "telephone_number": "920-885-5225",
            "fax_number": "920-356-6419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "CHERYL",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8342-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

Verify at the official NPI Registry.