Individual provider Active NPI

Maria Butler, ND

  • Pediatric Nutrition Registered Dietitian
  • Fort Myers, FL
National Provider Identifier
1154736213
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
ND4301 Issued in FL
Practice address
14180 Metropolis Ave
Suite 2
Fort Myers, FL 33912-4331
Phone
(239) 223-2751
Fax
(239) 561-2933
NPI assigned
Jun 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X ND4301 FL Primary

Addresses

Primary practice location

14180 Metropolis Ave
Suite 2
Fort Myers, FL 33912-4331

Mailing address

14180 Metropolis Ave
Suite 2
Fort Myers, FL 33912-4331
Phone (239) 223-2751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ND4301FLMDPediatric Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1154736213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14180 METROPOLIS AVE",
            "address_2": "SUITE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124331",
            "telephone_number": "239-223-2751",
            "fax_number": "239-561-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14180 METROPOLIS AVE",
            "address_2": "SUITE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124331",
            "telephone_number": "239-223-2751",
            "fax_number": "239-561-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "MARIA",
        "credential": "ND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "FL",
            "license": "ND4301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; 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.