Individual provider Active NPI

Elizabeth Megan Butcher

  • Licensed Practical Nurse
  • Charleston, WV
National Provider Identifier
1619793189
Registry record updated Nov 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
33521 Issued in WV
Practice address
100 Tracy Way
Charleston, WV 25311-1257
Phone
(304) 720-0205
NPI assigned
Nov 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 33521 WV Primary

Addresses

Primary practice location

100 Tracy Way
Charleston, WV 25311-1257

Mailing address

100 Tracy Way
Charleston, WV 25311-1257
Phone (304) 720-0205

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
33521WVMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1732838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732838400000",
    "number": "1619793189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TRACY WAY",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111257",
            "telephone_number": "304-720-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TRACY WAY",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111257",
            "telephone_number": "304-720-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTCHER",
        "first_name": "ELIZABETH",
        "middle_name": "MEGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-29",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "33521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.