Individual provider Active NPI

Michael Hunter Butcher

  • Behavior Technician
  • Merritt Island, FL
National Provider Identifier
1174031926
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
415 Hibiscus Blvd
Merritt Island, FL 32952-5070
Phone
(321) 961-7831
Fax
(407) 960-3009
NPI assigned
Jan 15, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X FL Primary

Addresses

Primary practice location

415 Hibiscus Blvd
Merritt Island, FL 32952-5070

Mailing address

475 S John Rodes Blvd
Melbourne, FL 32904-1093
Phone (321) 241-1170

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Sonder Academy Behavior Analyst PastSince Nov 1, 2020 Accepting new patients
Teaching Interventions Keeping Individuality, Inc Behavior Analyst Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1174031926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 S JOHN RODES BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329041093",
            "telephone_number": "321-241-1170",
            "fax_number": "321-241-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 HIBISCUS BLVD",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329525070",
            "telephone_number": "321-961-7831",
            "fax_number": "407-960-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTCHER",
        "first_name": "MICHAEL",
        "middle_name": "HUNTER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-15",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.