Individual provider Active NPI

Brynn Nikelen Butzman, OTD, OTR/L

  • Pediatric Occupational Therapist
  • Henderson, NV
National Provider Identifier
1942843958
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT-2389 Issued in NV
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, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
OT-2389NVMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ocealis Aesthetic, LLC Current Accepting new patients
Ocean of Change Therapy Services LLC Pediatrics CurrentSince Oct 27, 2019 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.

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.

Verify at the official NPI Registry.