Individual provider Active NPI

Lacinda Butler, WHNP

  • Women's Health Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1124015144
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
APN00000682525 Issued in TN
Practice address
244 Coatsland Dr
Jackson, TN 38301-3948
Phone
(731) 422-4642
Fax
(731) 422-2277
NPI assigned
Oct 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X APN00000682525 TN Primary

Addresses

Primary practice location

244 Coatsland Dr
Jackson, TN 38301-3948

Mailing address

244 Coatsland Dr
Jackson, TN 38301-3948
Phone (731) 422-4642

Other identifiers 1

IdentifierTypeStateIssuer
3908877MedicaidTN

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
I20101005000035 TN Practitioner - Nurse Practitioner 7810189263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Womans Clinic a Professional AssociationGroup PAC ID 1355308677, 15 clinicians

Practice addresses (Care Compare)

244 Coatsland Dr
Jackson, TN 38301-3948
Phone (731) 422-4642

Hospital & facility affiliations

  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
  • Hardin Medical Center Hospital, Savannah, TN, CCN 440109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN00000682525TNMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Womans Clinic a Professional Association CurrentSince Jun 7, 2010 Accepting new patients

Locations

244 Coatsland Dr
Jackson, TN 38301
Phone (731) 422-4642

Organizations & group practices 1

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.

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1124015144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 COATSLAND DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013948",
            "telephone_number": "731-422-4642",
            "fax_number": "731-422-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 COATSLAND DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013948",
            "telephone_number": "731-422-4642",
            "fax_number": "731-422-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "LACINDA",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TN",
            "license": "APN00000682525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3908877",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.