Individual provider Active NPI

Larry S. Butler, M.D.

  • Obstetrics & Gynecology Physician
  • Lexington, KY
National Provider Identifier
1053352500
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20759 Issued in KY
Practice address
3213 Summit Square PL
Suite 200
Lexington, KY 40509-2636
Phone
(859) 381-1066
Fax
(859) 263-0650
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 20759 KY Primary

Addresses

Primary practice location

3213 Summit Square PL
Suite 200
Lexington, KY 40509-2636

Mailing address

3213 Summit Square PL
Suite 200
Lexington, KY 40509-2636
Phone (859) 381-1066

Other identifiers 2

IdentifierTypeStateIssuer
000000290311OtherKYANTHEM
64207590MedicaidKY

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1053352500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3213 SUMMIT SQUARE PL",
            "address_2": "SUITE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092636",
            "telephone_number": "859-381-1066",
            "fax_number": "859-263-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3213 SUMMIT SQUARE PL",
            "address_2": "SUITE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092636",
            "telephone_number": "859-381-1066",
            "fax_number": "859-263-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "LARRY",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "20759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000290311",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64207590",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; 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.