Individual provider Active NPI

Frederick Clarence Butler Jr., M.D.

  • Ophthalmology Physician
  • Wilmington, NC
National Provider Identifier
1306945795
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
13071 Issued in NC
Practice address
3749 Reston CT
Wilmington, NC 28403-6170
Phone
(910) 395-9326
Fax
(910) 395-0198
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 13071 NC Primary

Addresses

Primary practice location

3749 Reston CT
Wilmington, NC 28403-6170

Mailing address

3749 Reston CT
Wilmington, NC 28403-6170
Phone (910) 395-9326

Other identifiers 1

IdentifierTypeStateIssuer
8920438MedicaidNC

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13071NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Eye Care P a Past Accepting new patients
Northern Eye Care P a Past Accepting new patients
Wilmington Eye, P.a. Ophthalmology Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306945795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3749 RESTON CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036170",
            "telephone_number": "910-395-9326",
            "fax_number": "910-395-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3749 RESTON CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036170",
            "telephone_number": "910-395-9326",
            "fax_number": "910-395-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "FREDERICK",
        "middle_name": "CLARENCE",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "13071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8920438",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

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.

Verify at the official NPI Registry.