Butler Medical Providers
Organization Active NPI Family Medicine Physician · Slippery Rock, PA
NPI 1104124916 · NPPES record last updated Oct 29, 2025
Key facts
- NPI
- 1104124916
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- BUTLER MEDICAL PROVIDERS
- Practice address
- 100 Innovation Drive
Suite 101
Slippery Rock, PA 16057 - Phone
- (833) 684-1891
- Fax
- (724) 794-3675
- NPI assigned
- Mar 2, 2011
- Organization subpart
- No
Authorized official
- Name
- Scott Madden
- Title
- Coo Physician Network
- Phone
- (724) 283-6666
Other NPIs on the same Medicare enrollment 35
Practitioners 8
-
Kimberley L Davis, CRNP
-
Abigail Mohrbacher, CRNP
-
Robin L Plank, D.O.
-
Hugh Shearer, D.O.
-
Karla Lynn Wilson, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D0709380 | BHS - Slippery Rock Family Medicine | Provider-performed microscopy | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040205000830 | PA | Part B Supplier - Clinic/Group Practice | 7416840160 |
Receives reassigned benefits from 562 practitioners 38 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
100 Innovation Dr
Ste 101
Slippery Rock, PA 16057
Phone (724) 794-4023
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
100 Innovation Drive
Suite 101
Slippery Rock, PA 16057
Mailing address
PO Box 641031
Pittsburgh, PA 15264-1031
Phone (877) 247-9925
Other names
- Slippery Rock Family Medicine Division
NPI Registry JSON
{
"created_epoch": "1299024000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761696000000",
"number": "1104124916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 641031",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152641031",
"telephone_number": "877-247-9925",
"fax_number": "724-284-4144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 INNOVATION DRIVE",
"address_2": "SUITE 101",
"city": "SLIPPERY ROCK",
"state": "PA",
"postal_code": "16057",
"telephone_number": "833-684-1891",
"fax_number": "724-794-3675"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BUTLER MEDICAL PROVIDERS",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-02",
"last_updated": "2025-10-29",
"certification_date": "2025-10-29",
"status": "A",
"authorized_official_last_name": "MADDEN",
"authorized_official_first_name": "SCOTT",
"authorized_official_title_or_position": "COO PHYSICIAN NETWORK",
"authorized_official_telephone_number": "724-283-6666"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Slippery Rock Family Medicine Division",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Slippery Rock Family Medicine Division",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Slippery Rock, PA
- Kristina Benkeser
- BHS Fastercare PLLC
- Abigail Leigh Biddle
- Erin Boyer
- S Dianne Broad
- Paul Andrew Cacolice
- Linda L Campbell
- Celestin Mindcare PLLC
- Teresa Lynn Celestin
- Charles R Nebel DC PC
All providers in Slippery Rock, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.