Susan Olive Duncan-Butler, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2001-00861 Issued in NC

Practice address

3614 Providence Rd S Ste 101
Waxhaw, NC 28173-6309

Phone

(704) 384-8460

Fax

(704) 384-8771

NPI assigned

Jun 30, 2005

Last updated

Oct 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba NHMG Primary Care Clinics

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Waxhaw Family & Sports Medicine

  • Family Medicine Physician
  • Waxhaw, NC
  • NPI 1568400729
  NPD
• Anson Regional Medical Services, Inc.

  • Community Health Clinic/Center
  • Morven, NC
  • NPI 1417073347
  NPD (past)
• Anson Regional Medical Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Monroe, NC
  • NPI 1649540105
  NPD (past)
• Novant Health Medical Group, LLC

  dba Novant Health Northlake Dermatology

  • Dermatopathology Physician
  • Huntersville, NC
  • NPI 1396751640
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1184621534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7840",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 PROVIDENCE RD S STE 101",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736309",
            "telephone_number": "704-384-8460",
            "fax_number": "704-384-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN-BUTLER",
        "first_name": "SUSAN",
        "middle_name": "OLIVE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2001-00861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NC8802C",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "130U1",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184621534",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sduncanbutler252630@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "3614 Providence Rd S Ste 101",
            "city": "Waxhaw",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281736309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thomas Doohan
• Kaitlyn Dorval
• Helen Sells Doss, MD
• Douglas a. Wolfe DDS PLLC (New Town Dentistry)
• Lauren Dujanovich, PHARMD
• Elisa Edgerton, FNP
• Mackenzie Gayle Edwards, PT, DPT
• Megan Efland, CCC-SLP
• El Rophe Center, Inc
• Elizabeth Lapenna, DMD, PLLC (Blue Sky Dentistry)

• Pediatrics Physician in Waxhaw, NC
• Providers in Waxhaw, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.