Renee Butler

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

702254 Issued in NY

Practice address

118 Freeville Rd
Dryden, NY 13053-9625

Phone

(607) 844-8694

NPI assigned

Aug 28, 2020

Last updated

Aug 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1215540356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LEISURE LN",
            "city": "FREEVILLE",
            "state": "NY",
            "postal_code": "130689521",
            "telephone_number": "607-793-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 FREEVILLE RD",
            "city": "DRYDEN",
            "state": "NY",
            "postal_code": "130539625",
            "telephone_number": "607-844-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "702254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Suzanne Boettger, SPEECH/LANGUAGE PATH
• Jeffrey Linn Bookhout, RPH
• Nicole Brinn
• Jennifer Elayne Bruer-Vandeweert
• James Douglas Bucko
• Dana Michelle Carruth, L.AC.
• Karyn Centro, RN
• Samantha Jane Clark, PHARM.D.
• Jason R Coburn, D.C.
• Elisabeth Corbett, PA

• Registered Nurse in Dryden, NY
• Providers in Dryden, NY by specialty
• Registered Nurse in New York

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