Individual provider Active NPI

Tiffany Michelle Butcher, APRN FNP-BC

  • Family Nurse Practitioner
  • Madison, WV
National Provider Identifier
1639845472
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
110267 Issued in WV
Practice address
Boone Memorial Hospital
701 Madison Avenue
Madison, WV 25130
Phone
(304) 369-1230
NPI assigned
Aug 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 110267 WV Primary

Addresses

Primary practice location

Boone Memorial Hospital
701 Madison Avenue
Madison, WV 25130

Mailing address

PO Box 542
Verdunville, WV 25649-0542
Phone (304) 601-2491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20211007002815 WV Practitioner - Nurse Practitioner 1850799602 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
West Virginia University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Logan General Hospital LLCGroup PAC ID 9537078977, 27 clinicians

Practice addresses (Care Compare)

38 Hospital Dr
Logan, WV 25601-3452
Phone (304) 831-1892

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Boone Memorial Hospital, Inc Current Accepting new patients
Boone Memorial Hospital, Inc CurrentSince Sep 1, 2021 Accepting new patients
Boone Memorial Hospital, Inc CurrentSince Sep 1, 2021 Accepting new patients
Appalachia Pathology Consultants LLC Current Accepting new patients
Boone Memorial Hospital, Inc Current Accepting new patients
Logan General Hospital LLC CurrentSince Jan 1, 2023 Accepting new patients
Boone Memorial Hospital, Inc Current Accepting new patients

Locations

1690 Holden Rd
Logan, WV 25601
Phone (304) 239-2147

20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101

38 Hospital Dr
Ste 1A
Logan, WV 25601
Phone (304) 831-1892

38 Hospital Dr
Logan, WV 25601
Phone (304) 792-6282

701 Madison Ave
Madison, WV 25130
Phone (304) 369-1230

660 S Main St
#A
Madison, WV 25130
Phone (304) 369-1230

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1639845472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 542",
            "city": "VERDUNVILLE",
            "state": "WV",
            "postal_code": "256490542",
            "telephone_number": "304-601-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BOONE MEMORIAL HOSPITAL",
            "address_2": "701 MADISON AVENUE",
            "city": "MADISON",
            "state": "WV",
            "postal_code": "25130",
            "telephone_number": "304-369-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTCHER",
        "first_name": "TIFFANY",
        "middle_name": "MICHELLE",
        "credential": "APRN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "110267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WV

Sources for this page

Verify at the official NPI Registry.