Individual provider Active NPI

Kayla Darsam Butler

  • Physical Therapy Assistant
  • Laguna Hills, CA
National Provider Identifier
1013764133
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
23001 Del Lago Dr
Laguna Hills, CA 92653-1354
Phone
(949) 387-7333
NPI assigned
May 6, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X Primary

Addresses

Primary practice location

23001 Del Lago Dr
Laguna Hills, CA 92653-1354

Mailing address

23001 Del Lago Dr
Laguna Hills, CA 92653-1354
Phone (949) 387-7333

Other practice location 1

4735 Perkins Rd Ste A
Baton Rouge, LA 70808-3040
Phone (225) 923-0110

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

Practice roles

OrganizationSpecialtyStatusNew patients
MC2 Enterprises, LLC PastSince May 1, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1013764133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23001 DEL LAGO DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531354",
            "telephone_number": "949-387-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23001 DEL LAGO DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531354",
            "telephone_number": "949-387-7333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4735 Perkins Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708083040",
            "country_code": "US",
            "telephone_number": "225-923-0110",
            "fax_number": "225-923-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "KAYLA",
        "middle_name": "DARSAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.