Kelly Brown Butkowski

Primary specialty

Social WorkerTaxonomy code 104100000X

License

9843 Issued in MN

Practice address

215 N Benton Dr
Sauk Rapids, MN 56379

Phone

(320) 281-2030

Fax

(320) 529-0747

NPI assigned

Aug 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Independent Lifestyles, Inc.

  • Case Management Agency
  • Sauk Rapids, MN
  • NPI 1144852732
  NPD

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1124638978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N BENTON DR",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "56379",
            "telephone_number": "320-281-2030",
            "fax_number": "320-529-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N BENTON DR",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "56379",
            "telephone_number": "320-281-2030",
            "fax_number": "320-529-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTKOWSKI",
        "first_name": "KELLY",
        "middle_name": "BROWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "9843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Diane Breitbach, OTR/L
• Bridge Recovery LLC
• Brookdale Senior Living Communities, Inc.
• Aaron Brummer, PHARM.D
• Jeremiah Luke Bursch, D.C.
• Becky Ann Canon, RN
• Care Medical Supply Inc
• Daniel T Carlson, D.C.
• Leah Christine Cathey, RN
• Cherrywood Advanced Living, LLC

• Social Worker in Sauk Rapids, MN
• Providers in Sauk Rapids, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.