Active NPI
Michael Douglas Butcher Sr., P.T.
- Physical Therapist
- Modesto, CA
National Provider Identifier
1275755548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 472
- Practice address
- 1500 Florida Ave
Modesto, CA 95350-4408 - Phone
- (209) 577-8570
- Fax
- (209) 572-0804
- NPI assigned
- May 3, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 472 | CA | Primary |
Addresses
Primary practice location
1500 Florida Ave
Modesto, CA 95350-4408
Mailing address
9429 California Oak Circle
Patterson, CA 95363
Phone (209) 892-6485
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 472 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275755548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9429 CALIFORNIA OAK CIRCLE",
"city": "PATTERSON",
"state": "CA",
"postal_code": "95363",
"telephone_number": "209-892-6485",
"fax_number": "209-892-6485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 FLORIDA AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953504408",
"telephone_number": "209-577-8570",
"fax_number": "209-572-0804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTCHER",
"first_name": "MICHAEL",
"middle_name": "DOUGLAS",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.