Individual provider Active NPI

Rachel A Butler, NNP

  • Neonatal Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1679592307
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
96418 Issued in AZ
Practice address
300 W Clarendon Ave
375
Phoenix, AZ 85013-3420
Phone
(602) 277-4161
Fax
(602) 274-3394
NPI assigned
Jul 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 96418 AZ Primary

Addresses

Primary practice location

300 W Clarendon Ave
375
Phoenix, AZ 85013-3420

Mailing address

300 W Clarendon Ave
375
Phoenix, AZ 85013-3420
Phone (602) 277-4161

Other identifiers 1

IdentifierTypeStateIssuer
695132MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20210430001347 NE Practitioner - Nurse Practitioner 4082023189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

7500 Mercy Rd
Omaha, NE 68124-2319
Phone (402) 398-5580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
96418AZMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Jan 29, 2021 Accepting new patients
Neonatology Associates, LTD Neonatal Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880

Organizations & group practices 2

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679592307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE",
            "address_2": "375",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133420",
            "telephone_number": "602-277-4161",
            "fax_number": "602-274-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE",
            "address_2": "375",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133420",
            "telephone_number": "602-277-4161",
            "fax_number": "602-274-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "RACHEL",
        "middle_name": "A",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AZ",
            "license": "96418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "695132",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.