Individual provider Active NPI

Kenneth Patrick Butler, DPT

  • Physical Therapist
  • Annapolis, MD
National Provider Identifier
1073284543
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12441920-2401 Issued in UT
Practice address
2000 Medical Pkwy Ste 404
Annapolis, MD 21401-3746
Phone
(443) 481-1140
NPI assigned
Sep 24, 2021
Last updated
Sep 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12441920-2401 UT Primary

Addresses

Primary practice location

2000 Medical Pkwy Ste 404
Annapolis, MD 21401-3746

Mailing address

8831 S Russell Park Rd
Salt Lake City, UT 84121-6140
Phone (801) 712-3251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211122000147 DC Practitioner - Physical Therapist in Private Practice 0345639928 Reassigns benefits to 2 organizations
I20211201000014 MD Practitioner - Physical Therapist in Private Practice 0345639928 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Luna Care Physical Therapy LLCGroup PAC ID 4284017419, 123 clinicians

Practice addresses (Care Compare)

5425 Wisconsin Ave
Suite 600
Chevy Chase, MD 20815-3588
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12441920-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jul 3, 2023 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Sep 27, 2021 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Sep 27, 2021 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Sep 27, 2021 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist Current Accepting new patients
Medstar Health Physical Therapy at Home, LLC. Physical Therapist CurrentSince Nov 16, 2023 Accepting new patients
Medstar Health Physical Therapy at Home, LLC. Physical Therapist CurrentSince Nov 16, 2023 Accepting new patients

Locations

161 Jennifer Rd
Ste A
Annapolis, MD 21401

4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190

6836 Race Track Rd
Bowie, MD 20715
Phone (301) 805-7004

5425 Wisconsin Ave
Ste 600
Chevy Chase, MD 20815
Phone (202) 223-3077

10980 Grantchester Way
Columbia, MD 21044
Phone (410) 772-6500

28438 Marlboro Ave
Easton, MD 21601
Phone (410) 820-7270

8638 Veterans Hwy
Fl 1
Millersville, MD 21108
Phone (410) 729-4508

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

7611 Crain Hwy
#C170
Upper Marlboro, MD 20772

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1073284543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8831 S RUSSELL PARK RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216140",
            "telephone_number": "801-712-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY STE 404",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013746",
            "telephone_number": "443-481-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "KENNETH",
        "middle_name": "PATRICK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-24",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12441920-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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.

Verify at the official NPI Registry.