Individual provider Active NPI

Colleen M Butler, FNP, RN

  • Family Nurse Practitioner
  • Sheridan, WY
National Provider Identifier
1669503025
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15246.0316 Issued in WY
Practice address
1333 W 5TH St Ste 103
Sheridan, WY 82801-2752
Phone
(307) 672-8921
Fax
(307) 672-3944
NPI assigned
Mar 8, 2007
Last updated
Aug 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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 15246.0316 WY Primary

Addresses

Primary practice location

1333 W 5TH St Ste 103
Sheridan, WY 82801-2752

Mailing address

1333 W 5TH St Ste 103
Sheridan, WY 82801-2752
Phone (307) 672-8921

Other identifiers 1

IdentifierTypeStateIssuer
120187500MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20130809000713 AK Order and Referring Only - Nurse Practitioner 7810950656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
15246.0316WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Family Practice, P.C. Family Past Accepting new patients
Strahan & Associates PC Past Accepting new patients
America's Family Doctors, PLLC PastSince Dec 1, 2005 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIFAAA

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1669503025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 W 5TH ST STE 103",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012752",
            "telephone_number": "307-672-8921",
            "fax_number": "307-672-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 W 5TH ST STE 103",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012752",
            "telephone_number": "307-672-8921",
            "fax_number": "307-672-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "15246.0316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120187500",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

Verify at the official NPI Registry.