Kage D Butcher, MSPT, ATC, CSCS
Individual provider Active NPI Physical Therapist · Lake Orion, MI
NPI 1386808152 · NPPES record last updated Jan 28, 2009
Key facts
- NPI
- 1386808152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501009997 (MI)
- Practice address
- 1210 S Lapeer Rd
Lake Orion, MI 48360-1433 - Phone
- (248) 814-8060
- Fax
- (248) 814-8070
- NPI assigned
- Jul 10, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109402413 | MI | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orion Physical Therapy, PLLC | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501009997 | MI | Yes |
| Athletic Trainer | 2255A2300X | 109402413 | MI |
Addresses
Primary practice location
1210 S Lapeer Rd
Lake Orion, MI 48360-1433
Mailing address
1210 S Lapeer Rd
Lake Orion, MI 48360-1433
Phone (248) 814-8060
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 650E61190 | Other | MI | BCBS |
Other providers in Lake Orion, MI
- Sydney Jean Bryce
- Rebecca Burger
- Emily Morgan Burrows
- Dawn Michele Burtnett
- Grace Catherine Busch
- Jessica Grace Butler
- Lorna Stratton Calbeck
- Summer Callahan
- Alexa Caporuscio
- Alexandra Nicole Hoskins Cargo
All providers in Lake Orion, MI · Physical Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.