Active NPI
Colton Phillip Butler, RN
- Certified Registered Nurse Anesthetist
- Edwardsville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209027723
- Practice address
- 6 Hairpin Dr
Edwardsville, IL 62026-1000 - Phone
- (618) 650-3956
- NPI assigned
- Oct 3, 2022
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2014009478 | MO | |
| Registered Nurse | 163W00000X | 041496067 | IL | |
| Registered Nurse | 163W00000X | 2014009478 | IL | |
| Certified Registered Nurse Anesthetist | 367500000X | 209027723 | IL | Primary |
Addresses
Primary practice location
6 Hairpin Dr
Edwardsville, IL 62026-1000
Mailing address
620 N Church St
Belleville, IL 62220-4031
Phone (618) 520-7140
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230711001643 | IL | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 8426417239 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North American Partners in Anesthesia Illinois LLC
Practice addresses (Care Compare)
1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120
Hospital & facility affiliations
- HSHS St Elizabeth'S Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041496067 | IL | MD | Registered Nurse |
| 2014009478 | IL | MD | Registered Nurse |
| 2014009478 | MO | MD | Registered Nurse |
| 209027723 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North American Partners in Anesthesia (Illinois), LLC | Current | Accepting new patients |
Locations
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
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.
-
- Anesthesiology Physician
- Oak Park, IL
- NPI 1699032524
IL
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- O Fallon, IL
- NPI 1629057302
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700352000000",
"number": "1063136133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 N CHURCH ST",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622204031",
"telephone_number": "618-520-7140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 HAIRPIN DR",
"city": "EDWARDSVILLE",
"state": "IL",
"postal_code": "620261000",
"telephone_number": "618-650-3956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "COLTON",
"middle_name": "PHILLIP",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-03",
"last_updated": "2023-11-19",
"certification_date": "2023-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2014009478",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041496067",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "2014009478",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209027723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edwardsville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.