Patricia B Butler, NP
Individual provider Active NPI Nurse Practitioner · Savannah, GA
NPI 1104861004 · NPPES record last updated May 23, 2008
Key facts
- NPI
- 1104861004
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN093087 (GA)
- Practice address
- 5 Executive Cir
Savannah, GA 31406-3345 - Phone
- (912) 355-2400
- Fax
- (912) 355-5324
- NPI assigned
- Jun 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101103000492 | GA | Practitioner - Nurse Practitioner | 2365636396 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN093087 | GA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Josephs Candler Urgent Care Centers LLC | Current |
Accepting new patients | |
| St Josephs Candler Urgent Care Centers LLC | Current |
Accepting new patients | |
| Georgia Emergency Associates | Current |
Accepting new patients | |
| Advanced Pediatric Specialists LLC | Past | Accepting new patients |
Locations
780 E Oglethorpe Hwy
Hinesville, GA 31313
Phone (912) 332-7262
107 Canal St
Pooler, GA 31322
Phone (912) 450-1945
101 Saint Josephs Candler Dr
Ste 100
Pooler, GA 31322
Phone (912) 450-1945
5621 Highway 21 S
Rincon, GA 31326
Phone (912) 295-5860
361 Commercial Dr
#F
Savannah, GA 31406
Phone (912) 355-2400
11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452
361 Commercial Dr
Savannah, GA 31406
Phone (912) 355-6221
5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172
1499 Fair Rd
Statesboro, GA 30458
Phone (912) 486-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN093087 | GA | Yes |
Addresses
Primary practice location
5 Executive Cir
Savannah, GA 31406-3345
Mailing address
5 Executive Cir
Savannah, GA 31406-3345
Phone (912) 355-2400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000764849 | Medicaid | GA | |
| 000764849B | Medicaid | GA | |
| 10059058 | Other | GA | AMERIGROUP |
| 000764849C | Medicaid | GA |
Other providers in Savannah, GA
- Andrew Butler
- April Leigh Butler
- Brian Butler
- Grace Butler
- Lakeisha Butler
- Patrice H Butterfield
- By Your Side Home Care Inc
- Liza Byars
- Peggy L. Byck
- Andrea Byers
All providers in Savannah, GA · Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2008. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.