Active NPI
David Lee Butler, PH.D.
- Clinical Neuropsychologist
- North Miami Beach, FL
National Provider Identifier
1417014069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PY4064
- Practice address
- 1835 NE Miami Gardens Dr
#316
North Miami Beach, FL 33179-5035 - Phone
- (704) 640-3264
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PY4064 | FL | Primary |
| Psychologist | 103T00000X | PY4064 | FL | |
| Cognitive & Behavioral Psychologist | 103TB0200X | PY4064 | FL | |
| Clinical Psychologist | 103TC0700X | PY4064 | FL | |
| Forensic Psychologist | 103TF0200X | PY4064 | FL | |
| Rehabilitation Psychologist | 103TR0400X | PY4064 | FL |
Addresses
Primary practice location
1835 NE Miami Gardens Dr
#316
North Miami Beach, FL 33179-5035
Mailing address
1835 NE Miami Gardens Dr
#316
North Miami Beach, FL 33179-5035
Phone (704) 640-3264
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY4064 | FL | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221264000000",
"number": "1417014069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1835 NE MIAMI GARDENS DR",
"address_2": "#316",
"city": "NORTH MIAMI BEACH",
"state": "FL",
"postal_code": "331795035",
"telephone_number": "704-640-3264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1835 NE MIAMI GARDENS DR",
"address_2": "#316",
"city": "NORTH MIAMI BEACH",
"state": "FL",
"postal_code": "331795035",
"telephone_number": "704-640-3264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "DAVID",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2008-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "FL",
"license": "PY4064",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY4064",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "FL",
"license": "PY4064",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY4064",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "FL",
"license": "PY4064",
"primary": false
},
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "FL",
"license": "PY4064",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Miami Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.