Individual provider Active NPI

Janette Ethel Butler, CNP/C.N.M

  • Nurse Practitioner
  • Midland, MI
National Provider Identifier
1760473565
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704134869 Issued in MI
Practice address
4401 N Campus RDG Dr Ste Ll110
Midland, MI 48640-6126
Phone
(989) 837-9400
NPI assigned
Oct 31, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 4704134869 MI
Advanced Practice Midwife 367A00000X 4704134869 MI
Nurse Practitioner 363L00000X 4704134869 MI Primary

Addresses

Primary practice location

4401 N Campus RDG Dr Ste Ll110
Midland, MI 48640-6126

Mailing address

4401 N Campus Ridge Dr Ste B2200
Midland, MI 48640-6193
Phone (989) 837-9400

Other identifiers 1

IdentifierTypeStateIssuer
M41070-028OtherMICHIGAN MEDICARE

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)
Enrolled
Credentials
Certified Nurse Midwife, Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704134869MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Group PastSince Jul 24, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1760473565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 N CAMPUS RIDGE DR STE B2200",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406193",
            "telephone_number": "989-837-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 N CAMPUS RDG DR STE LL110",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406126",
            "telephone_number": "989-837-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JANETTE",
        "middle_name": "ETHEL",
        "name_prefix": "Mrs.",
        "credential": "CNP/C.N.M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704134869",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704134869",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704134869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN MEDICARE",
            "identifier": "M41070-028",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.