Active NPI
Willie M Butler, LPN
- Licensed Practical Nurse
- Thornwood, NY
National Provider Identifier
1902028426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 115882
- Practice address
- 501 Swanson Drive
Thornwood, NY 10594 - Phone
- (914) 769-3630
- NPI assigned
- May 3, 2007
- Last updated
- Feb 26, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 115882 | NY | Primary |
Addresses
Primary practice location
501 Swanson Drive
Thornwood, NY 10594
Mailing address
90 Manhattan Ave
White Plains, NY 10603
Phone (914) 426-4211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02276240 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 115882 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203984000000",
"number": "1902028426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 MANHATTAN AVE",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "10603",
"telephone_number": "914-426-4211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 SWANSON DRIVE",
"city": "THORNWOOD",
"state": "NY",
"postal_code": "10594",
"telephone_number": "914-769-3630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "WILLIE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2008-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "115882",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02276240",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Thornwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.