Individual provider Active NPI

Phyllis K Butler, FNP

  • Family Nurse Practitioner
  • Mariposa, CA
National Provider Identifier
1508921487
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0073142-22 Issued in CA
Practice address
5300 Hwy 49 N.
Mariposa, CA 95338
Phone
(209) 966-3672
Fax
(209) 966-5548
NPI assigned
Dec 22, 2006
Last updated
Sep 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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 0073142-22 CA Primary

Addresses

Primary practice location

5300 Hwy 49 N.
Mariposa, CA 95338

Mailing address

PO Box 3768
Merced, CA 95344-3768
Phone (209) 725-7149

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

State licenses

LicenseStateTypeSpecialty
0073142-22CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1508921487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3768",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953443768",
            "telephone_number": "209-725-7149",
            "fax_number": "209-726-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 HWY 49 N.",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "95338",
            "telephone_number": "209-966-3672",
            "fax_number": "209-966-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "PHYLLIS",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "0073142-22",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mariposa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.