Active NPI
Clyde Wilson Butler, MS, CCC-SLP
- Speech-Language Pathologist
- Scottsboro, AL
National Provider Identifier
1386818318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2159
- Practice address
- 380 Woods Cove Rd
Scottsboro, AL 35768-2428 - Phone
- (256) 259-4840
- Fax
- (256) 259-4830
- NPI assigned
- Apr 22, 2008
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2159 | AL | Primary |
Addresses
Primary practice location
380 Woods Cove Rd
Scottsboro, AL 35768-2428
Mailing address
380 Woods Cove Rd
PO Box 1050
Scottsboro, AL 35768-2428
Phone (256) 259-4840
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2159 | Other | AL | STATE OF AL LICENSE |
| 515-20510 | Other | AL | BCBS |
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1386818318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380 WOODS COVE RD",
"address_2": "PO BOX 1050",
"city": "SCOTTSBORO",
"state": "AL",
"postal_code": "357682428",
"telephone_number": "256-259-4840",
"fax_number": "256-259-4830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 WOODS COVE RD",
"city": "SCOTTSBORO",
"state": "AL",
"postal_code": "357682428",
"telephone_number": "256-259-4840",
"fax_number": "256-259-4830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "CLYDE",
"middle_name": "WILSON",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-22",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "2159",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF AL LICENSE",
"identifier": "2159",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "515-20510",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scottsboro, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.