Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Butts, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1063936482

Kelly Butts, FNP-BC is a Nurse Practitioner in New York, New York. Qualified in 2017, 9 years ago. Practices with Trustees of Columbia University in the City of New York, a 2,250-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
9
Licensed in
NY
In the registry since
2017
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

622 W 168th St
New York, NY 10032-3720
Phone: (212) 305-6494
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 432288 (NY)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 342011 (NY)

Record details

NPI number1063936482
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedJuly 27, 2017
Last updated in NPPESSeptember 10, 2024
Certification dateSeptember 10, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Trustees Of Columbia University In The City Of New York — 2250 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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