Individual provider Active NPI

Nicole D Butero, MS-CCC-SLP

  • Speech-Language Pathologist
  • Pewaukee, WI
National Provider Identifier
1730416074
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3313154 Issued in WI
Practice address
W254N5055 McKerrow Dr
Pewaukee, WI 53072-1304
Phone
(262) 246-5905
NPI assigned
Nov 6, 2009
Last updated
Nov 6, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3313154 WI Primary

Addresses

Primary practice location

W254N5055 McKerrow Dr
Pewaukee, WI 53072-1304

Mailing address

W254 N5055 McKerrow Drive
Pewaukee, WI 53072
Phone (262) 246-5905

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
3313154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1730416074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W254 N5055 MCKERROW DRIVE",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "53072",
            "telephone_number": "262-246-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W254N5055 MCKERROW DR",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530721304",
            "telephone_number": "262-246-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTERO",
        "first_name": "NICOLE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "MS-CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "3313154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.