Individual provider Active NPI

Clint Chachere Butler, MD

  • Family Medicine Physician
  • Haynesville, LA
National Provider Identifier
1306876826
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
023033 Issued in LA
Practice address
926 Frances Dr
Haynesville, LA 71038-6100
Phone
(318) 624-0554
Fax
(318) 624-3782
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 023033 LA Primary

Addresses

Primary practice location

926 Frances Dr
Haynesville, LA 71038-6100

Mailing address

926 Frances Dr
Haynesville, LA 71038-6100
Phone (318) 624-0554

Other identifiers 1

IdentifierTypeStateIssuer
1493929MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041106000030 LA Practitioner - Family Practice 2567423155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Homer Memorial HospitalGroup PAC ID 1456322692, 22 clinicians

Practice addresses (Care Compare)

620 E College St
Homer, LA 71040-3202
Phone (318) 927-2024

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.86 of 100Reported as group
Quality
91.31
Promoting interoperability
95
Improvement activities
40
Cost
79.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
023033LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Homer Memorial Hospital CurrentSince Jan 1, 2000 Accepting new patients
Homer Memorial Hospital CurrentSince Jan 1, 2000 Accepting new patients
Homer Memorial Hospital Past Accepting new patients
Tri-State Health Services of Cenla, LLC Past Accepting new patients

Locations

926 Frances Dr
Haynesville, LA 71038
Phone (318) 624-0554

104 Morris Cir
Homer, LA 71040
Phone (318) 927-1110

620 E College St
Homer, LA 71040
Phone (318) 927-2024

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Heritage Nursing CenterHaynesville, LA, CCN 195518 Skilled nursing facility Adp of the SNF Jun 1, 1999

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1306876826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 FRANCES DR",
            "city": "HAYNESVILLE",
            "state": "LA",
            "postal_code": "710386100",
            "telephone_number": "318-624-0554",
            "fax_number": "318-624-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 FRANCES DR",
            "city": "HAYNESVILLE",
            "state": "LA",
            "postal_code": "710386100",
            "telephone_number": "318-624-0554",
            "fax_number": "318-624-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "CLINT",
        "middle_name": "CHACHERE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "023033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1493929",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haynesville, LA

Sources for this page

Verify at the official NPI Registry.