Individual provider Active NPI

Jada McGirt Butler, FNP

  • Nurse Practitioner
  • Shallotte, NC
National Provider Identifier
1194422329
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5017556 Issued in NC
Practice address
512 Village Rd Ste 205
Shallotte, NC 28470-3409
Phone
(910) 754-4441
Fax
(910) 754-5307
NPI assigned
Feb 8, 2023
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5017556 NC Primary

Addresses

Primary practice location

512 Village Rd Ste 205
Shallotte, NC 28470-3409

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 374-8284

Other practice location 2

512 Village Rd Ste 103
Shallotte, NC 28470-3409
Phone (910) 754-4441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230330002026 NC Practitioner - Nurse Practitioner 6709251994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

512 Village Rd
Suite 103
Shallotte, NC 28470-3409
Phone (910) 754-4441

5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 754-4441

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5017556NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Mar 9, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Mar 9, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Mar 9, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

512 Village Rd
Ste 103
Shallotte, NC 28470
Phone (910) 754-4441

512 Village Rd
Ste 205
Shallotte, NC 28470
Phone (910) 721-4230

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: jbutler1121074@direct.novanthealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1194422329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 VILLAGE RD STE 205",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284703409",
            "telephone_number": "910-754-4441",
            "fax_number": "910-754-5307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5145 Sellers Rd",
            "address_purpose": "LOCATION",
            "city": "Shallotte",
            "state": "NC",
            "postal_code": "284703405",
            "country_code": "US",
            "telephone_number": "910-374-8284",
            "fax_number": "910-754-5307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "512 Village Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Shallotte",
            "state": "NC",
            "postal_code": "284703409",
            "country_code": "US",
            "telephone_number": "910-754-4441",
            "fax_number": "910-754-5307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JADA",
        "middle_name": "MCGIRT",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5017556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

Verify at the official NPI Registry.