Individual provider Active NPI

Staci Lynn Butkus, NP

  • Family Nurse Practitioner
  • Saint Clairsville, OH
National Provider Identifier
1306147640
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.11975 Issued in OH
Practice address
109 Plaza Dr
Saint Clairsville, OH 43950-7713
Phone
(740) 695-5200
Fax
(740) 695-8037
NPI assigned
Nov 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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 APRN.CNP.11975 OH Primary

Addresses

Primary practice location

109 Plaza Dr
Saint Clairsville, OH 43950-7713

Mailing address

109 Plaza Dr
Saint Clairsville, OH 43950-9773
Phone (740) 695-5200

Other identifiers 3

IdentifierTypeStateIssuer
3122356MedicaidOH
1045407010001MedicaidPA
3810019462MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20110119000012 OH Practitioner - Nurse Practitioner 6709075096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity WestGroup PAC ID 5496648875, 145 clinicians

Practice addresses (Care Compare)

109 Plaza Dr
Saint Clairsville, OH 43950-7713
Phone (740) 283-7143

Hospital & facility affiliations

  • Trinity Medical Ctr East &Trinity Medical Ctr West Hospital, Steubenville, OH, CCN 360211
  • Wheeling Hospital, Inc Hospital, Wheeling, WV, CCN 510050
  • Reynolds Memorial Hospital, Inc Hospital, Glen Dale, WV, CCN 510013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.11975OHMDFamily Nurse Practitioner

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.

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": "1288742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1306147640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 PLAZA DR",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439509773",
            "telephone_number": "740-695-5200",
            "fax_number": "740-695-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PLAZA DR",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439507713",
            "telephone_number": "740-695-5200",
            "fax_number": "740-695-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTKUS",
        "first_name": "STACI",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-03",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.11975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3122356",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1045407010001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810019462",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clairsville, OH

Sources for this page

Verify at the official NPI Registry.