Active NPI
Bryan Butler, ATC
- Athletic Trainer
- Lincoln, NE
National Provider Identifier
1013453208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 945
- Practice address
- 2635 N 63Rd St
Lincoln, NE 68507-2422 - Phone
- (402) 429-1799
- NPI assigned
- Jan 11, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT.0001925 | CO | |
| Athletic Trainer | 2255A2300X | 945 | NE | Primary |
Addresses
Primary practice location
2635 N 63Rd St
Lincoln, NE 68507-2422
Mailing address
1521 Kingston Rd
Lincoln, NE 68506-1524
Other practice location 1
5000 Saint Paul Ave
Lincoln, NE 68504
Phone (402) 429-1799
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 |
|---|---|---|---|
| AT.0001925 | CO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556236800000",
"number": "1013453208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1521 KINGSTON RD",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685061524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2635 N 63RD ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685072422",
"telephone_number": "402-429-1799"
}
],
"practiceLocations": [
{
"address_1": "5000 Saint Paul Ave",
"address_purpose": "LOCATION",
"city": "Lincoln",
"state": "NE",
"postal_code": "68504",
"country_code": "US",
"telephone_number": "402-429-1799",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUTLER",
"first_name": "BRYAN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-11",
"last_updated": "2019-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CO",
"license": "AT.0001925",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NE",
"license": "945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.