Justin Sean Butler, MD, SA-C

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

21-139

Practice address

250 Pharr Rd NE Apt 1307
Atlanta, GA 30305-2278

Phone

(864) 354-1323

NPI assigned

Apr 13, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1013597145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PHARR RD NE APT 1307",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052278",
            "telephone_number": "864-354-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PHARR RD NE APT 1307",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052278",
            "telephone_number": "864-354-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JUSTIN",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "MD, SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": "21-139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "justinsb1988@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "250 Pharr Rd NE Apt 1307",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303052278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joanna Cassandra Butler, CCC-SLP
• Joelle Kristin Butler, M.S.W., L.C.S.W.
• John Butler
• Jordan Alexandra Butler, LPC
• Juanita Butler
• Kay LH Butler, LCSW
• Lauren Elizabeth Butler, LPC
• Michell B Butler, PHARM.D.
• Rochelle Antoinette Butler, DDS
• Samantha Nicole Butler, CAA

• All providers in Atlanta, GA
• Surgical Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.