Individual provider Active NPI

Jennifer K Button, PA-C

  • Physician Assistant
  • Canon City, CO
National Provider Identifier
1013913086
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1165 Issued in CO
Practice address
715 S 9TH St
Canon City, CO 81212-4911
Phone
(719) 269-8820
Fax
(719) 204-0230
NPI assigned
Jun 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1165 CO Primary

Addresses

Primary practice location

715 S 9TH St
Canon City, CO 81212-4911

Mailing address

715 S 9TH St
Canon City, CO 81212-4911
Phone (719) 269-8820

Other names 1

  • Jennifer K Button Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051004000214 CO Practitioner - Physician Assistant 3375578941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Button Family Practice PCGroup PAC ID 0840225413, 9 clinicians

Practice addresses (Care Compare)

715 S 9TH St
Canon City, CO 81212-4911
Phone (269) 753-4125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1165COMDClinical Neuropsychologist

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Button Family Practice PCCanon City, CO, CCN 063866 Rural health clinic Corporate Director
W-2 Managing Employee
Nov 7, 2005
May 17, 2001

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1013913086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 S 9TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124911",
            "telephone_number": "719-269-8820",
            "fax_number": "719-204-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S 9TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124911",
            "telephone_number": "719-269-8820",
            "fax_number": "719-204-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTON",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-24",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BUTTON",
            "middle_name": "K",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Canon City, CO

Sources for this page

Verify at the official NPI Registry.