Individual provider Active NPI

Shirlee Eliazard-Butler

  • Registered Nurse
  • Spring Valley, NY
National Provider Identifier
1831418193
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
805035 Issued in NY
Practice address
78 W Sneden PL
Spring Valley, NY 10977-3909
Phone
(845) 222-8466
NPI assigned
May 26, 2010
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 805035 NY Primary
Licensed Practical Nurse 164W00000X 01000293535 NY

Addresses

Primary practice location

78 W Sneden PL
Spring Valley, NY 10977-3909

Mailing address

78 W Sneden PL
Spring Valley, NY 10977-3909
Phone (845) 222-8466

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
805035NYMDRegistered Nurse
01000293535NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1831418193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 W SNEDEN PL",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109773909",
            "telephone_number": "845-222-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 W SNEDEN PL",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109773909",
            "telephone_number": "845-222-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIAZARD-BUTLER",
        "first_name": "SHIRLEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-26",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "805035",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "01000293535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.