Kenneth T Butler, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0000000564 Issued in TN

Practice address

325 Cherry Ave
MC Kenzie, TN 38201-1769

Phone

(731) 415-2701

NPI assigned

Oct 6, 2005

Last updated

Oct 18, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1396733044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 CHERRY AVE",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011769",
            "telephone_number": "731-415-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CHERRY AVE",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011769",
            "telephone_number": "731-415-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "KENNETH",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "0000000564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "62-0548913",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas E Brown, MD
• Michael Lee Bryant, MD
• Brittany Burkett
• Brooke Spivey Burress, OD
• Cassie Denise Butler, PTA
• Rustin Forest Cameron, PA-C
• Elijah Carpenter, FNP
• CCC Medical Equipment, Inc.
• Briana Page Chandler, FNP-C
• Philemon D Chang, M.D.

• Athletic Trainer in McKenzie, TN
• Providers in McKenzie, TN by specialty
• Athletic Trainer in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.