Individual provider Active NPI

Jessica Lynn Butcher, LPA

  • Psychologist
  • Charlotte, NC
National Provider Identifier
1639660830
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5289 Issued in NC
Practice address
8401 University Exec Park Dr Ste 106
Charlotte, NC 28262-1360
Phone
(800) 311-7072
NPI assigned
May 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5289 NC Primary

Addresses

Primary practice location

8401 University Exec Park Dr Ste 106
Charlotte, NC 28262-1360

Mailing address

4102 Breezewood Dr Apt 104
Wilmington, NC 28412-5159
Phone (910) 391-5187

Other practice location 1

2353 Concord Lake Rd Ste 160
Concord, NC 28025-2892
Phone (800) 311-7072

Other practice location 2

624 W Main St
Yadkinville, NC 27055-7804
Phone (800) 311-7072

Other practice location 3

542 Brookdale Dr
Statesville, NC 28677-4108
Phone (800) 311-7072

Other practice location 4

919 N Main St Ste B
Mooresville, NC 28115-2355
Phone (800) 311-7072

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
5289NCMDAudiologist-Hearing Aid Fitter

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1639660830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 BREEZEWOOD DR APT 104",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284125159",
            "telephone_number": "910-391-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 UNIVERSITY EXEC PARK DR STE 106",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621360",
            "telephone_number": "800-311-7072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2353 Concord Lake Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252892",
            "country_code": "US",
            "telephone_number": "800-311-7072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "624 W Main St",
            "address_purpose": "LOCATION",
            "city": "Yadkinville",
            "state": "NC",
            "postal_code": "270557804",
            "country_code": "US",
            "telephone_number": "800-311-7072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "542 Brookdale Dr",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286774108",
            "country_code": "US",
            "telephone_number": "800-311-7072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "919 N Main St Ste B",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281152355",
            "country_code": "US",
            "telephone_number": "800-311-7072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTCHER",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "5289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.