Individual provider Active NPI

Brooke V Butler, FNP

  • Family Nurse Practitioner
  • Knox, IN
National Provider Identifier
1114385879
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006066A Issued in IN
Practice address
104 E Culver Rd
106
Knox, IN 46534-2241
Phone
(574) 772-7400
Fax
(574) 772-0299
NPI assigned
Feb 9, 2016
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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 71006066A IN Primary

Addresses

Primary practice location

104 E Culver Rd
106
Knox, IN 46534-2241

Mailing address

104 E Culver Rd
106
Knox, IN 46534-2241

Other identifiers 2

IdentifierTypeStateIssuer
201349000MedicaidIN
193380045OtherINMEDICARE PTAN-B

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brooke.butler@healthlinc.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160419000321 IN Practitioner - Nurse Practitioner 5496053860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Indiana University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthlinc IncGroup PAC ID 7618929373, 83 clinicians

Practice addresses (Care Compare)

104 E Culver Rd
Healthlinc Knox
Knox, IN 46534-2204
Phone (574) 772-7400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71006066AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthlinc, Inc. Current Accepting new patients
Healthlinc, Inc CurrentSince Mar 13, 2016 Accepting new patients
Healthlinc, Inc CurrentSince Mar 13, 2016 Accepting new patients

Locations

104 E Culver Rd
Knox, IN 46534
Phone (574) 772-7400

104 E Culver Rd
Ste 106
Knox, IN 46534
Phone (574) 772-7400

1001 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-7173

2401 Valley Dr
Valparaiso, IN 46383
Phone (219) 413-5100

Interoperability endpoints

  • Direct secure messaging: brooke.butler@healthlinc.directbygreenway.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1114385879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E CULVER RD",
            "address_2": "106",
            "city": "KNOX",
            "state": "IN",
            "postal_code": "465342241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E CULVER RD",
            "address_2": "106",
            "city": "KNOX",
            "state": "IN",
            "postal_code": "465342241",
            "telephone_number": "574-772-7400",
            "fax_number": "574-772-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "BROOKE",
        "middle_name": "V",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-09",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006066A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201349000",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN-B",
            "identifier": "193380045",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brooke.butler@healthlinc.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "104 E Culver Rd",
            "address_2": "106",
            "city": "Knox",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465342241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knox, IN

Sources for this page

Verify at the official NPI Registry.