Organization Active NPI

Kelly Ann Butler Family Nurse Practitioner,PLLC

  • Nurse Practitioner
  • Oneonta, NY
National Provider Identifier
1891991501
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
332310 Issued in NY
Legal business name
KELLY ANN BUTLER FAMILY NURSE PRACTITIONER,PLLC
Practice address
438 Main St
Oneonta, NY 13820-2058
Phone
(607) 432-7900
Fax
(607) 432-7903
NPI assigned
Jun 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Kelly Ann Butler, FNP
Title
Family Nurse Practitioner
Phone
(607) 432-7900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 332310 NY Primary

Addresses

Primary practice location

438 Main St
Oneonta, NY 13820-2058

Mailing address

438 Main St
Oneonta, NY 13820-2058
Phone (607) 432-7900

Other identifiers 1

IdentifierTypeStateIssuer
02848135MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1891991501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 MAIN ST",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138202058",
            "telephone_number": "607-432-7900",
            "fax_number": "607-432-7903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 MAIN ST",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138202058",
            "telephone_number": "607-432-7900",
            "fax_number": "607-432-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY ANN BUTLER FAMILY NURSE PRACTITIONER,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "607-432-7900",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "332310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02848135",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneonta, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.