Individual provider Active NPI

Terry Thomas Butkus, APRN

  • Family Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1366570020
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
110626 Issued in NE
Practice address
16101 Evans St
Omaha, NE 68116-6447
Phone
(402) 717-9797
NPI assigned
Mar 2, 2007
Last updated
Jun 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 110626 NE Primary
Family Nurse Practitioner 363LF0000X A097758 IA

Addresses

Primary practice location

16101 Evans St
Omaha, NE 68116-6447

Mailing address

11305 Old Maple Rd
Omaha, NE 68164-2630
Phone (402) 498-8984

Other practice location 1

1288 Valley View Dr
Council Bluffs, IA 51503
Phone (712) 328-8800

Other practice location 2

3010 23rd St
Columbus, NE 68601-3122
Phone (402) 563-0242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110626NEMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1366570020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11305 OLD MAPLE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681642630",
            "telephone_number": "402-498-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16101 EVANS ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681166447",
            "telephone_number": "402-717-9797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1288 Valley View Dr",
            "address_purpose": "LOCATION",
            "city": "Council Bluffs",
            "state": "IA",
            "postal_code": "51503",
            "country_code": "US",
            "telephone_number": "712-328-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3010 23rd St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "NE",
            "postal_code": "686013122",
            "country_code": "US",
            "telephone_number": "402-563-0242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTKUS",
        "first_name": "TERRY",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110626",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A097758",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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.