Individual provider Active NPI

Jonathan Douglas Butler, RN, EMT

  • Registered Nurse
  • Rochester, MN
National Provider Identifier
1174405591
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
199401-8 Issued in MN
Practice address
2110 E Center St
Rochester, MN 55904-4754
Phone
(507) 287-0674
NPI assigned
Jul 24, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 199401-8 MN Primary

Addresses

Primary practice location

2110 E Center St
Rochester, MN 55904-4754

Mailing address

918 1St Ave NW
Byron, MN 55920-1410
Phone (641) 420-8238

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
Credentials
Emergency Medical Technician, Registered Nurse

State licenses

LicenseStateTypeSpecialty
199401-8MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
US Department of Justice PastSince Jul 28, 2025 Accepting new patients
Mayo Clinic PastSince Jul 28, 2025 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": "1753315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1174405591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 1ST AVE NW",
            "city": "BYRON",
            "state": "MN",
            "postal_code": "559201410",
            "telephone_number": "641-420-8238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 E CENTER ST",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559044754",
            "telephone_number": "507-287-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JONATHAN",
        "middle_name": "DOUGLAS",
        "credential": "RN, EMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "199401-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.