Justin Butler, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11035870 Issued in FL

Practice address

1542 Kingsley Ave Ste 136-137
Orange Park, FL 32073-4586

Phone

(239) 690-6906

NPI assigned

Oct 16, 2024

Last updated

Oct 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dna Comprehensive Therapy Services LLCGroup PAC ID 2860619632, 446 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: justin.butler.1@13142.direct.athenahealth.com

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.

• Dna Comprehensive Therapy Services, LLC

  dba Elite DNA Therapy Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Myers, FL
  • NPI 1316363757
  Medicare reassignment Care Compare group NPD
• Bonita Springs Retirement Village, Inc.

  dba The Terraces at Bonita Springs

  • Skilled Nursing Facility
  • Bonita Springs, FL
  • NPI 1700126802
  NPD

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1538989264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4153 FISHING CREEK LN",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320683986",
            "telephone_number": "904-210-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 KINGSLEY AVE STE 136-137",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734586",
            "telephone_number": "239-690-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JUSTIN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11035870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Michael Burnham, D.C.
• Samantha Burrows
• Cecelia Anne Bushery, LMHC
• Allison Dasta Butler, M.D.
• Dawn Butler
• Kassandra Leann Butler, ARNP
• Sarah Nicole Butler
• Mujtaba I Butt, M.D.
• Nicole Marie Buzard, PA-C
• Miashia Byrd

• Psychiatric/Mental Health Nurse Practitioner in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.