Individual provider Active NPI

Jennifer Daneen Butts, CRNA, RN

  • Certified Registered Nurse Anesthetist
  • Placerville, CA
National Provider Identifier
1447701909
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
100740 Issued in CA
Practice address
4671 Mount Aukum Rd
Placerville, CA 95667-9501
Phone
(913) 217-0536
NPI assigned
Oct 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 803436 CA
Certified Registered Nurse Anesthetist 367500000X 100740 CA Primary

Addresses

Primary practice location

4671 Mount Aukum Rd
Placerville, CA 95667-9501

Mailing address

4671 Mount Aukum Rd
Placerville, CA 95667-9501
Phone (913) 217-0536

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
803436CAMDCritical Care Medicine Registered Nurse
100740CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1447701909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4671 MOUNT AUKUM RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956679501",
            "telephone_number": "913-217-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4671 MOUNT AUKUM RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956679501",
            "telephone_number": "913-217-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTS",
        "first_name": "JENNIFER",
        "middle_name": "DANEEN",
        "credential": "CRNA, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "803436",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "100740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.