Individual provider Active NPI

Jennifer Andy Butler, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Clermont, FL
National Provider Identifier
1780464495
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11033693 Issued in FL
Practice address
17011 State Road 50 Ste 301
Clermont, FL 34711-8203
Phone
(833) 769-3524
Fax
(833) 769-3524
NPI assigned
Oct 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11033693 FL Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 9501507 FL

Addresses

Primary practice location

17011 State Road 50 Ste 301
Clermont, FL 34711-8203

Mailing address

17011 State Road 50 Ste 301
Clermont, FL 34711-8203
Phone (833) 769-3524

Other practice location 1

5226 Cape Hatteras Dr
Clermont, FL 34714-7248
Phone (954) 592-2735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241122004303 FL Practitioner - Nurse Practitioner 2365977675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

17011 State Rd
50 Suite 301
Clermont, FL 34711-8203
Phone (352) 833-6300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9501507FLMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Aug 11, 2025 Accepting new patients

Locations

17011 State Road 50
Ste 301
Clermont, FL 34711
Phone (352) 833-6300

8570 Granite Ct
Ste 101
Fort Myers, FL 33908
Phone (239) 310-4646

260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.jenniferbutler@141363.advancedmd-direct.com

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": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1780464495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17011 STATE ROAD 50 STE 301",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118203",
            "telephone_number": "833-769-3524",
            "fax_number": "352-432-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17011 STATE ROAD 50 STE 301",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118203",
            "telephone_number": "833-769-3524",
            "fax_number": "833-769-3524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5226 Cape Hatteras Dr",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347147248",
            "country_code": "US",
            "telephone_number": "954-592-2735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JENNIFER",
        "middle_name": "ANDY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11033693",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9501507",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.