Active NPI
Brynn Nikelen Butzman, OTD, OTR/L
- Pediatric Occupational Therapist
- Henderson, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT-2389
- Practice address
- 10907 S Eastern Ave Ste 100
Henderson, NV 89052-5863 - Phone
- (702) 867-4266
- Fax
- (702) 867-4261
- NPI assigned
- Oct 22, 2019
- Last updated
- Oct 22, 2019
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT-2389 | NV | Primary |
Addresses
Primary practice location
10907 S Eastern Ave Ste 100
Henderson, NV 89052-5863
Mailing address
2505 Anthem Village Dr Ste E380
Henderson, NV 89052-5505
Phone (702) 867-4266
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 |
|---|---|---|---|
| OT-2389 | NV | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ocealis Aesthetic, LLC | Current | Accepting new patients | |
| Ocean of Change Therapy Services LLC | Pediatrics | Current | Accepting new patients |
| Tiltons Therapy Inc | Past | Accepting new patients | |
| Good Life Therapy, LLC | Past | Accepting new patients | |
| Debbie Tilton Otrl Inc | Pediatrics | Past | Accepting new patients |
Locations
10907 S Eastern Ave
Ste 100
Henderson, NV 89052
Phone (702) 565-3824
2505 Anthem Village Dr
Ste E380
Henderson, NV 89052
Organizations & group practices 5
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.
-
- Occupational Therapist
- Las Vegas, NV
- NPI 1053289439
-
- Pediatric Occupational Therapist
- Henderson, NV
- NPI 1770126443
Pediatrics
-
dba Tiltons Therapy For Tots
- Occupational Therapist
- Las Vegas, NV
- NPI 1740323674
Pediatrics
-
- Occupational Therapist
- Las Vegas, NV
- NPI 1700211182
-
- Occupational Therapist
- Las Vegas, NV
- NPI 1235799941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571702400000",
"number": "1942843958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2505 ANTHEM VILLAGE DR STE E380",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890525505",
"telephone_number": "702-867-4266",
"fax_number": "702-867-4261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10907 S EASTERN AVE STE 100",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890525863",
"telephone_number": "702-867-4266",
"fax_number": "702-867-4261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTZMAN",
"first_name": "BRYNN",
"middle_name": "NIKELEN",
"name_prefix": "Miss",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-22",
"last_updated": "2019-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NV",
"license": "OT-2389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.