Individual provider Active NPI

Rosanne Butera, DC

  • Chiropractor
  • Austin, TX
National Provider Identifier
1205836178
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5617 Issued in TX
Practice address
1803 W 35TH St
Suite a
Austin, TX 78703-1370
Phone
(512) 323-6767
Fax
(512) 302-0244
NPI assigned
Jul 21, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5617 TX Primary

Addresses

Primary practice location

1803 W 35TH St
Suite a
Austin, TX 78703-1370

Mailing address

1803 W 35TH St
Suite a
Austin, TX 78703-1370
Phone (512) 323-6767

Other identifiers 1

IdentifierTypeStateIssuer
C03603623MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101109000826 TX Practitioner - Chiropractic 9436344041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Butera Chiropractic LLC Chiropractor CurrentSince Feb 1, 2012 Accepting new patients
35TH St Physical Therapy PLLC PastSince May 6, 2012 Accepting new patients

Locations

1803 W 35th St
Ste A
Austin, TX 78703
Phone (512) 323-6767

Organizations & group practices 2

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1205836178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 W 35TH ST",
            "address_2": "SUITE A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787031370",
            "telephone_number": "512-323-6767",
            "fax_number": "512-302-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 W 35TH ST",
            "address_2": "SUITE A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787031370",
            "telephone_number": "512-323-6767",
            "fax_number": "512-302-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTERA",
        "first_name": "ROSANNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "5617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C03603623",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.