Individual provider Active NPI

Destiny Ricki Butler, NP

  • Family Nurse Practitioner
  • Gwynn Oak, MD
National Provider Identifier
1518836121
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R254665 Issued in MD
Practice address
6340 Security Blvd
Gwynn Oak, MD 21207-5173
Phone
(443) 909-9869
NPI assigned
Nov 3, 2025
Last updated
Mar 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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 R254665 MD Primary
Registered Nurse 163W00000X R254665 MD

Addresses

Primary practice location

6340 Security Blvd
Gwynn Oak, MD 21207-5173

Mailing address

6340 Security Blvd
Gwynn Oak, MD 21207-5173
Phone (443) 909-9869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20260505004183 MD Practitioner - Nurse Practitioner 3870061179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1931 Woodlawn Dr
Gwynn Oak, MD 21207-4210

6340 Security Blvd
Suite 100
Gwynn Oak, MD 21207-5284

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R254665MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pretti Ricki Healing Hands LLC Current Accepting new patients

Locations

6340 Security Blvd
Ste 100
Woodlawn, MD 21207
Phone (443) 413-9942

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1518836121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6340 SECURITY BLVD",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212075173",
            "telephone_number": "443-909-9869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6340 SECURITY BLVD",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212075173",
            "telephone_number": "443-909-9869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "DESTINY",
        "middle_name": "RICKI",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-03",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R254665",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R254665",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gwynn Oak, MD

Sources for this page

Verify at the official NPI Registry.