NPIMap

Individual provider Active NPI

Patricia A Butler, CRNP

  • Family Nurse Practitioner
  • Snow Shoe, PA
National Provider Identifier
1245546472
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP010869 Issued in PA
Practice address
402 E Sycamore Rd
Snow Shoe, PA 16874
Phone
(814) 387-6857
Fax
(814) 387-6870
NPI assigned
Aug 25, 2010
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP010869 PA Primary

Addresses

Primary practice location

402 E Sycamore Rd
Snow Shoe, PA 16874

Mailing address

90 E 2ND St
Emporium, PA 15834-1302
Phone (814) 486-1115

Other identifiers 1

IdentifierTypeStateIssuer
1028829500011MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000805 PA Practitioner - Nurse Practitioner 2769399799 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Care of Pennsylvania LLCGroup PAC ID 0143521211, 91 clinicians
Clearfield Professional Group, LTD.Group PAC ID 7214827914, 4 clinicians

Practice addresses (Care Compare)

2109 Red Lion Rd
Philadelphia, PA 19115-1711
Phone (718) 298-4375

820 Turnpike Ave
Clearfield, PA 16830-1229
Phone (814) 765-2411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP010869PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care of Pennsylvania LLC CurrentSince Feb 15, 2026 Accepting new patients

Locations

2109 Red Lion Rd
Philadelphia, PA 19115
Phone (215) 213-7000

Organizations & group practices 3

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 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1245546472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 E 2ND ST",
            "city": "EMPORIUM",
            "state": "PA",
            "postal_code": "158341302",
            "telephone_number": "814-486-1115",
            "fax_number": "814-486-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E SYCAMORE RD",
            "city": "SNOW SHOE",
            "state": "PA",
            "postal_code": "16874",
            "telephone_number": "814-387-6857",
            "fax_number": "814-387-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-25",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP010869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028829500011",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snow Shoe, PA

Sources for this page

Verify at the official NPI Registry.