Active NPI
Steven C Butler, M.D.
- Nephrology Physician
- Kingsport, TN
National Provider Identifier
1174514228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 021779
- Practice address
- 2002 Brookside Dr
Suite 102
Kingsport, TN 37660-4634 - Phone
- (423) 245-6000
- Fax
- (423) 245-6062
- NPI assigned
- Oct 28, 2005
- Last updated
- Jan 28, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 021779 | TN | Primary |
Addresses
Primary practice location
2002 Brookside Dr
Suite 102
Kingsport, TN 37660-4634
Mailing address
2002 Brookside Dr
Suite 102
Kingsport, TN 37660-4634
Phone (423) 245-6000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 850101 | Other | TN | JOHN DEERE HEALTH |
| 165323 | Other | TN | BLUE CROSS BLUE SHIELD |
| 6002048 | Medicaid | VA | |
| 3063437 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- University of Chicago, Pritzker School of Medicine, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2002 Brookside Dr
Suite 102
Kingsport, TN 37660-4634
Phone 4232456000211
Hospital & facility affiliations
- FMC West Kingsport
- Wellmont Holston Valley Medical Center
- Indian Path Community Hospital
- Wellmont Bristol Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021779 | TN | MD | Nephrology Physician |
Interoperability endpoints
- sbutler12084@direct.acumenmd.com
Organizations & group practices 1
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.
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Bma West Kingsport
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Kingsport, TN
- NPI 1982706305
Dialysis facility
-
dba Indian Path Community Hospital
- General Acute Care Hospital
- Kingsport, TN
- NPI 1992813240
-
dba Bristol Regional Medical Center
- General Acute Care Hospital
- Bristol, TN
- NPI 1124058615
-
dba Holston Valley Medical Center
- General Acute Care Hospital
- Kingsport, TN
- NPI 1487690400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580169600000",
"number": "1174514228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2002 BROOKSIDE DR",
"address_2": "SUITE 102",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376604634",
"telephone_number": "423-245-6000",
"fax_number": "423-245-6062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2002 BROOKSIDE DR",
"address_2": "SUITE 102",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376604634",
"telephone_number": "423-245-6000",
"fax_number": "423-245-6062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "STEVEN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-28",
"last_updated": "2020-01-28",
"certification_date": "2020-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "TN",
"license": "021779",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE HEALTH",
"identifier": "850101",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "165323",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6002048",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3063437",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.