Individual provider Active NPI

Shahid Butt, MD

  • Obstetrics & Gynecology Physician
  • Chardon, OH
National Provider Identifier
1194815431
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35043284B Issued in OH
Practice address
13207 Ravenna Rd
Chardon, OH 44024-7032
Phone
(440) 285-6000
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X 35043284B OH
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 35043284B OH
General Practice Physician 208D00000X 35043284B OH
Obstetrics & Gynecology Physician 207V00000X 35043284B OH Primary

Addresses

Primary practice location

13207 Ravenna Rd
Chardon, OH 44024-7032

Mailing address

24701 Euclid Ave
Euclid, OH 44117-1714
Phone (440) 285-6000

Other identifiers 1

IdentifierTypeStateIssuer
0473116MedicaidOH

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35043284BOHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fortaleza,LLC Addiction Medicine PastSince Aug 22, 2017 Accepting new patients
University Primary Care Practices Inc Past Accepting new patients
Southwest Medical Care Corporation Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1194815431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714",
            "telephone_number": "440-285-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13207 RAVENNA RD",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440247032",
            "telephone_number": "440-285-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTT",
        "first_name": "SHAHID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "OH",
            "license": "35043284B",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "OH",
            "license": "35043284B",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35043284B",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35043284B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0473116",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2017; 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.