Active NPI
Rex Travis Butler, DDS
- Periodontics
- Phoenix, AZ
National Provider Identifier
1245348705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 6876
- Practice address
- 6601 N Arizona Biltmore Cir
Phoenix, AZ 85016-8907 - Phone
- (602) 281-2717
- NPI assigned
- Aug 26, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 14729 | TX | |
| Periodontics | 1223P0300X | 2490 | AR | |
| Periodontics | 1223P0300X | 6876 | AZ | Primary |
Addresses
Primary practice location
6601 N Arizona Biltmore Cir
Phoenix, AZ 85016-8907
Mailing address
6601 N Arizona Biltmore Cir
Phoenix, AZ 85016-8907
Phone (602) 281-2717
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160916002024 | AZ | Order and Referring Only - Other (Non-Physician) | 5698062719 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14729 | TX | MD | Clinical Social Worker |
| 2490 | AR | MD | Periodontist |
| 6876 | AZ | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244419200000",
"number": "1245348705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6601 N ARIZONA BILTMORE CIR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850168907",
"telephone_number": "602-281-2717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6601 N ARIZONA BILTMORE CIR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850168907",
"telephone_number": "602-281-2717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "REX",
"middle_name": "TRAVIS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-26",
"last_updated": "2009-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "14729",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "AR",
"license": "2490",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "AZ",
"license": "6876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; 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.