Individual provider Active NPI

G. Nathan Butterworth, OD

  • Corneal and Contact Management Optometrist
  • Martinsville, VA
National Provider Identifier
1114928934
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
1944 Issued in NC
Practice address
1975 Virginia Ave
Martinsville, VA 24112-8388
Phone
(276) 647-3937
Fax
(276) 647-3990
NPI assigned
Aug 2, 2005
Reactivated
Jun 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001415 VA
Corneal and Contact Management Optometrist 152WC0802X 1944 NC Primary

Addresses

Primary practice location

1975 Virginia Ave
Martinsville, VA 24112-8388

Mailing address

1975 Virginia Ave
Martinsville, VA 24112-8388
Phone (276) 647-3937

Other identifiers 1

IdentifierTypeStateIssuer
010103282MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160810000829 NC Practitioner - Optometry 9335112192 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardinal Eye Care ODGroup PAC ID 7012245202, 2 clinicians
Ae EyecareGroup PAC ID 0042733131, 2 clinicians

Practice addresses (Care Compare)

3316 Silas Creek Pkwy
Winston Salem, NC 27103-3011
Phone (336) 765-5350

6270 Towncenter Dr
Clemmons, NC 27012-9376
Phone (336) 712-4733

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cardinal Eye Care OD Corneal and Contact Management CurrentSince Apr 23, 2019 Accepting new patients
Ae Eyecare CurrentSince Jan 1, 2025 Accepting new patients
Town Center Vision Optometrists P.a. Optometrist PastSince Jan 1, 2025 Accepting new patients
Friedrichs Family Eye Center PC Optometrist Past Accepting new patients

Locations

6270 Towncenter Dr
Clemmons, NC 27012
Phone (336) 712-4733

3316 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 765-5350

Interoperability endpoints

  • Direct secure messaging: nathan.butterworth@uprisedirect.com

Organizations & group practices 4

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1114928934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 VIRGINIA AVE",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241128388",
            "telephone_number": "276-647-3937",
            "fax_number": "276-647-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 VIRGINIA AVE",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241128388",
            "telephone_number": "276-647-3937",
            "fax_number": "276-647-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTERWORTH",
        "first_name": "G.",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "deactivation_date": "2019-06-05",
        "reactivation_date": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001415",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NC",
            "license": "1944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010103282",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsville, VA

Sources for this page

Verify at the official NPI Registry.