Jeffery Miles Butler, M.D.

Key facts

NPI

1104036359

Entity type

Individual (NPI type 1)

Primary specialty

Surgery Physician 208600000X

License

68488 (GA)

Practice address

11 Cross St
Hazlehurst, GA 31539-6427

Phone

(912) 699-6530

Fax

(912) 699-6535

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

No

Organizations & group practices 9

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.

• Hospital Authority of Jeff Davis County Georgia Critical Access Hospital · Hazlehurst, GA · NPI 1912902263
  Medicare reassignment Care Compare group NPD GA
• Southland Optim Screven Emergency Medical Services LLC Emergency Medicine Physician · Sylvania, GA · NPI 1174917157
  Medicare reassignment Care Compare group NPD GA
• Southland Dodge Emergency Medical Services, LLC Emergency Medicine Physician · Eastman, GA · NPI 1851958607
  Medicare reassignment NPD GA
• Hospital Authority of Jeff Davis County Georgia Rural Health Clinic/Center · Hazlehurst, GA · NPI 1912379082
  Care Compare group NPD (past)
• Hospital Authority of Jeff Davis County Georgia Medicare Defined Swing Bed Hospital Unit · Hazlehurst, GA · NPI 1205229994
  Care Compare group
• Hospital Authority of Jeff Davis County Georgia Internal Medicine Physician · Hazlehurst, GA · NPI 1528874518
  NPD
• Hospital Authority of Jeff Davis County Georgia Specialist · Hazlehurst, GA · NPI 1578334264
  NPD
• The Baxley and Appling County Hospital Authority Rural Health Clinic/Center · Baxley, GA · NPI 1073752143
  NPD (past)
• Hyperbaric & Woundcare Inc Undersea and Hyperbaric Medicine (Preventive Medicine) Physician · Tampa, FL · NPI 1457308173
  NPD (past)

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Georgia, L.L.C. Home Health Agency · Waycross, GA · NPI 1316120322
  Care Compare affiliation Home health agency
• Hospital Authority of Jeff Davis County Georgia Critical Access Hospital · Hazlehurst, GA · NPI 1912902263
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

General Surgery

Education

Mercer University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Authority of Jeff Davis County Georgia (11 clinicians)
Southland Optim Screven Emergency Medical Services LLC (19 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency · Waycross, GA · CCN 117076
• Jeff Davis Hospital Hospital · Hazlehurst, GA · CCN 111333

Procedures performed for Medicare patients

Medicare participation

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffery.butler.1@4060.direct.athenahealth.com

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 10, 2025.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1104036359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 S TALLAHASSEE ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396465",
            "telephone_number": "912-699-6530",
            "fax_number": "912-699-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CROSS ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396427",
            "telephone_number": "912-699-6530",
            "fax_number": "912-699-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JEFFERY",
        "middle_name": "MILES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "68488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003127563B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Hazlehurst, GA · Surgery Physician in Georgia