Individual provider Active NPI

Lisette Iris Shanhai Butler, MSN,RN,AHN-BC,HWN-BC

  • General Practice Registered Nurse
  • Winter Park, FL
National Provider Identifier
1568223634
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
RN9223047 Issued in FL
Practice address
2921 Rouen Ave
Winter Park, FL 32789-1125
Phone
(321) 217-1980
NPI assigned
Jan 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WG0000X RN9223047 FL Primary

Addresses

Primary practice location

2921 Rouen Ave
Winter Park, FL 32789-1125

Mailing address

2921 Rouen Ave
Winter Park, FL 32789-1125
Phone (321) 217-1980

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
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9223047FLMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1568223634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 ROUEN AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891125",
            "telephone_number": "321-217-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 ROUEN AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891125",
            "telephone_number": "321-217-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANHAI BUTLER",
        "first_name": "LISETTE",
        "middle_name": "IRIS",
        "name_prefix": "Ms.",
        "credential": "MSN,RN,AHN-BC,HWN-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "RN9223047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.