Active NPI
Clark David Butler, PHARMD, MBA
- Pharmacist
- Richmond, VA
National Provider Identifier
1194966952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202215621
- Practice address
- 9458 Creek Summit Cir
Richmond, VA 23235-4277 - Phone
- (314) 369-2988
- Fax
- (636) 230-2988
- NPI assigned
- Mar 9, 2009
- Last updated
- Nov 27, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23256 | TX | |
| Pharmacist | 183500000X | 044890 | MO | |
| Pharmacist | 183500000X | 0202215621 | VA | Primary |
Addresses
Primary practice location
9458 Creek Summit Cir
Richmond, VA 23235-4277
Mailing address
9458 Creek Summit Cir
Richmond, VA 23235-4277
Phone (314) 369-2988
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
- Credentials
- Master of Business Administration, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202215621 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511740800000",
"number": "1194966952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9458 CREEK SUMMIT CIR",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232354277",
"telephone_number": "314-369-2988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9458 CREEK SUMMIT CIR",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232354277",
"telephone_number": "314-369-2988",
"fax_number": "636-230-2988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "CLARK",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PHARMD, MBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-09",
"last_updated": "2017-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "23256",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "044890",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202215621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.