Individual provider Active NPI

Carolyn Kay Butler

  • Primary Care Nurse Practitioner
  • Vista, CA
National Provider Identifier
1801889506
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
CA400963 NP8386 Issued in CA
Practice address
910 Sycamore Ave
Suite 270
Vista, CA 92081-7832
Phone
(760) 598-1700
Fax
(760) 598-1196
NPI assigned
Aug 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X CA400963 NP8386 CA Primary

Addresses

Primary practice location

910 Sycamore Ave
Suite 270
Vista, CA 92081-7832

Mailing address

910 Sycamore Ave
Suite 270
Vista, CA 92081-7832
Phone (760) 598-1700

Other identifiers 1

IdentifierTypeStateIssuer
RN8386MedicaidCA

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8386CAMDMarriage & Family Therapist
CA400963 NP8386CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen Dent M.D. Inc. Past 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, 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": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1801889506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 SYCAMORE AVE",
            "address_2": "SUITE 270",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920817832",
            "telephone_number": "760-598-1700",
            "fax_number": "760-598-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 SYCAMORE AVE",
            "address_2": "SUITE 270",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920817832",
            "telephone_number": "760-598-1700",
            "fax_number": "760-598-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "CAROLYN",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "CA400963 NP8386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN8386",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.