Individual provider Active NPI

Anne Elisabeth Butts, NP

  • Nurse Practitioner
  • Adrian, MI
National Provider Identifier
1689863391
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704238096 Issued in MI
Practice address
777 Kimole LN
Ste. 260
Adrian, MI 49221-1478
Phone
(517) 265-4770
NPI assigned
Oct 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704238096 MI Primary

Addresses

Primary practice location

777 Kimole LN
Ste. 260
Adrian, MI 49221-1478

Mailing address

777 Kimole LN
Ste. 260
Adrian, MI 49221-1478
Phone (517) 265-4770

Other identifiers 1

IdentifierTypeStateIssuer
4704238096OtherMISTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abutts14000@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20080703000169 MI Practitioner - Nurse Practitioner 0143392332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 E Russell Rd
Unit C
Tecumseh, MI 49286-2072
Phone (517) 263-9491

777 Kimole LN
Adrian, MI 49221-1400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704238096MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Corporation of Michigan CurrentSince Nov 17, 2017 Accepting new patients

Locations

777 Kimole Ln
Ste 230
Adrian, MI 49221
Phone (517) 263-5655

777 Kimole Ln
Ste 260
Adrian, MI 49221
Phone (419) 479-2650

777 Kimole Ln
Adrian, MI 49221
Phone (517) 263-3393

200 E Russell Rd
Unit C
Tecumseh, MI 49286
Phone (517) 424-3883

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

1 Seagate
Ste 800
Toledo, OH 43604

Interoperability endpoints

  • Direct secure messaging: abutts14000@direct.promedica.org

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1689863391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 KIMOLE LN",
            "address_2": "STE. 260",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211478",
            "telephone_number": "517-265-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 KIMOLE LN",
            "address_2": "STE. 260",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211478",
            "telephone_number": "517-265-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTS",
        "first_name": "ANNE",
        "middle_name": "ELISABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704238096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4704238096",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abutts14000@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.