Individual provider Active NPI

Janet Stark Buttermore, PT

  • Pediatric Physical Therapist
  • San Diego, CA
National Provider Identifier
1083634588
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT 9593 Issued in CA
Practice address
11858 Bernardo Plaza CT
Suite 110
San Diego, CA 92128-2439
Phone
(858) 673-5437
Fax
(858) 673-5434
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Electrophysiology Physical Therapist 2251E1300X EK 24 CA
Pediatric Physical Therapist 2251P0200X PT 9593 CA Primary

Addresses

Primary practice location

11858 Bernardo Plaza CT
Suite 110
San Diego, CA 92128-2439

Mailing address

11506 Mesa Madera CT
San Diego, CA 92131-1918
Phone (858) 693-3563

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

State licenses

LicenseStateTypeSpecialty
EK 24CAMDClinical Electrophysiology Physical Therapist
PT 9593CAMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1083634588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11506 MESA MADERA CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311918",
            "telephone_number": "858-693-3563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11858 BERNARDO PLAZA CT",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282439",
            "telephone_number": "858-673-5437",
            "fax_number": "858-673-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTERMORE",
        "first_name": "JANET",
        "middle_name": "STARK",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "CA",
            "license": "EK 24",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "PT 9593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.