NPIMap

Individual provider Active NPI

Mandy Yvonne Buttrum, MD

  • Family Medicine Physician
  • Henderson, NV
National Provider Identifier
1306070552
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15199 Issued in NV
Practice address
660 S Green Valley Pkwy Ste 130
Henderson, NV 89052-0431
Phone
(702) 470-2800
Fax
(702) 478-9354
NPI assigned
May 2, 2009
Last updated
Dec 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15199 NV Primary

Addresses

Primary practice location

660 S Green Valley Pkwy Ste 130
Henderson, NV 89052-0431

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (702) 616-5801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20140815001091 NV Practitioner - Family Practice 2062669153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avandy Medical Buttrum PLLCGroup PAC ID 1456733674, 3 clinicians

Practice addresses (Care Compare)

660 S Green Valley Pkwy
Suite 130
Henderson, NV 89052-0431
Phone (702) 470-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Avandy Medical Buttrum PLLC Family Medicine CurrentSince Apr 9, 2022 Accepting new patients
Henderson Hospital Past Accepting new patients
Desert View Regional Medical Center Holdings, LLC Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
North Vista Hospital LLC Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients

Locations

660 S Green Valley Pkwy
Ste 130
Henderson, NV 89052
Phone (702) 470-2800

Interoperability endpoints

  • Direct secure messaging: avandymedicalbuttrumpllc.mandybuttrum@152744.advancedmd-direct.com
  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1241222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1306070552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "702-616-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S GREEN VALLEY PKWY STE 130",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890520431",
            "telephone_number": "702-470-2800",
            "fax_number": "702-478-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTRUM",
        "first_name": "MANDY",
        "middle_name": "YVONNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-02",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "15199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.