Individual provider Active NPI

Roberta Lee Butler, P.T.

  • Physical Therapist
  • Port Townsend, WA
National Provider Identifier
1174867444
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00003888 Issued in WA
Practice address
1637 Grant St
Grant St. Elementary School
Port Townsend, WA 98368-7622
Phone
(360) 379-4260
Fax
(360) 379-4548
NPI assigned
Nov 26, 2012
Last updated
Nov 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00003888 WA Primary

Addresses

Primary practice location

1637 Grant St
Grant St. Elementary School
Port Townsend, WA 98368-7622

Mailing address

1619 Blaine St
Port Townsend, WA 98368-6405
Phone (360) 379-4260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT00003888WAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1174867444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 BLAINE ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983686405",
            "telephone_number": "360-379-4260",
            "fax_number": "360-379-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1637 GRANT ST",
            "address_2": "GRANT ST. ELEMENTARY SCHOOL",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983687622",
            "telephone_number": "360-379-4260",
            "fax_number": "360-379-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "ROBERTA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00003888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Townsend, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.