Individual provider Active NPI

Danielle Marie Butkowski, OTR/L

  • Occupational Therapist
  • Flowood, MS
National Provider Identifier
1184818577
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT1368 Issued in MS
Practice address
4215 Lakeland Dr
Flowood, MS 39232-9212
Phone
(601) 932-8555
NPI assigned
Aug 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT1368 MS Primary

Addresses

Primary practice location

4215 Lakeland Dr
Flowood, MS 39232-9212

Mailing address

711 Avignon Dr
Ridgeland, MS 39157-5120
Phone (601) 605-6777

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
OT1368MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Rehabilitation Inc Occupational Therapist Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1184818577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 AVIGNON DR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575120",
            "telephone_number": "601-605-6777",
            "fax_number": "601-813-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329212",
            "telephone_number": "601-932-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTKOWSKI",
        "first_name": "DANIELLE",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT1368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.