Organization Active NPI

Imdad H Butt MD PC

  • Internal Medicine Physician
  • Jackson, MI
National Provider Identifier
1003118217
Registry record updated Nov 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
IMDAD H BUTT MD PC
Practice address
2575 Spring Arbor Rd
Suite 200
Jackson, MI 49203-3652
Phone
(517) 784-0020
Fax
(517) 787-8329
NPI assigned
Nov 19, 2010
Last updated
Nov 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2010

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

Authorized official

Name
Dr. Imdad H Butt, MDNPI 1548210487
Title
President
Phone
(517) 784-0020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

2575 Spring Arbor Rd
Suite 200
Jackson, MI 49203-3652

Mailing address

2575 Spring Arbor Rd
Suite 200
Jackson, MI 49203-3652
Phone (517) 784-0020

Other names 1

  • DIAGNOSTIC ULTRASOUND CLINIC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101222000781 MI Part B Supplier - Clinic/Group Practice 5890983530 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0378524Imdad H Butt MD PC2575 Spring Arbor Rd, Jackson, MI 49203Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

2575 Spring Arbor Rd
Ste 200
Jackson, MI 49203
Phone (517) 784-0020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290124800000",
    "number": "1003118217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 SPRING ARBOR RD",
            "address_2": "SUITE 200",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033652",
            "telephone_number": "517-784-0020",
            "fax_number": "517-787-8329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 SPRING ARBOR RD",
            "address_2": "SUITE 200",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033652",
            "telephone_number": "517-784-0020",
            "fax_number": "517-787-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMDAD H BUTT MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2010-11-19",
        "status": "A",
        "authorized_official_last_name": "BUTT",
        "authorized_official_first_name": "IMDAD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-784-0020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIAGNOSTIC ULTRASOUND CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.