Active NPI
Roland T Butler Jr., P.T.
- Orthopedic Physical Therapist
- Suffolk, VA
National Provider Identifier
1376967117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 2305204886
- Practice address
- 5859 Harbor View Blvd
100
Suffolk, VA 23435-3015 - Phone
- (757) 686-0205
- NPI assigned
- Feb 14, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 2305204886 | VA | Primary |
Addresses
Primary practice location
5859 Harbor View Blvd
100
Suffolk, VA 23435-3015
Mailing address
5859 Harbor View Blvd
100
Suffolk, VA 23435-3015
Phone (757) 686-0205
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 |
|---|---|---|---|
| 2305204886 | VA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392336000000",
"number": "1376967117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5859 HARBOR VIEW BLVD",
"address_2": "100",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234353015",
"telephone_number": "757-686-0205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5859 HARBOR VIEW BLVD",
"address_2": "100",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234353015",
"telephone_number": "757-686-0205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "ROLAND",
"middle_name": "T",
"name_suffix": "Jr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-14",
"last_updated": "2014-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "VA",
"license": "2305204886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.