Organization Active NPI

Grant Butterbaugh PHD LLC

  • Clinical Neuropsychologist
  • New Orleans, LA
National Provider Identifier
1194129445
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
681 Issued in LA
Legal business name
GRANT BUTTERBAUGH PHD LLC
Practice address
3525 Prytania St
Suite 309
New Orleans, LA 70115-3500
Phone
(504) 309-9855
Fax
(504) 814-4346
NPI assigned
Oct 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Authorized official

Name
Dr. Grant Jackson Butterbaugh Jr., PH.D.
Title
Manager
Phone
(504) 309-9855

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X 681 LA Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 681 LA

Addresses

Primary practice location

3525 Prytania St
Suite 309
New Orleans, LA 70115-3500

Mailing address

3525 Prytania St
Suite 309
New Orleans, LA 70115-3500
Phone (504) 309-9855

National Provider Directory

National Provider Directory

Locations

3525 Prytania St
Ste 309
New Orleans, LA 70115
Phone (504) 488-8852

NPI Registry JSON

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1194129445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 PRYTANIA ST",
            "address_2": "SUITE 309",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701153500",
            "telephone_number": "504-309-9855",
            "fax_number": "504-814-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 PRYTANIA ST",
            "address_2": "SUITE 309",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701153500",
            "telephone_number": "504-309-9855",
            "fax_number": "504-814-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT BUTTERBAUGH PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-15",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "BUTTERBAUGH",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "504-309-9855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "LA",
            "license": "681",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "681",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.