Organization Active NPI

Christopher Butler DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Coeur d'Alene, ID
National Provider Identifier
1407047608
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
P-195 Issued in ID
Legal business name
CHRISTOPHER BUTLER DPM PC
Practice address
2221 N Ironwood Center Dr
Coeur D Alene, ID 83814-2697
Phone
(208) 667-3585
Fax
(866) 433-2607
NPI assigned
Aug 5, 2007
Last updated
Feb 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Authorized official

Name
Christopher Butler, DPMNPI 1659590677
Title
President
Phone
(208) 667-3585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X P-195 ID Primary

Addresses

Primary practice location

2221 N Ironwood Center Dr
Coeur D Alene, ID 83814-2697

Mailing address

2221 N Ironwood Center Dr
Coeur D Alene, ID 83814-2697
Phone (208) 667-3585

Other identifiers 1

IdentifierTypeStateIssuer
807822600MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071010000163 ID Part B Supplier - Clinic/Group Practice 0042306888 Receives reassigned benefits from 1 practitioner
Practice locations: Coeur D Alene, ID

National Provider Directory

National Provider Directory

Locations

2221 W Ironwood Center Dr
Coeur D Alene, ID 83814
Phone (208) 667-0635

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1407047608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 N IRONWOOD CENTER DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142697",
            "telephone_number": "208-667-3585",
            "fax_number": "866-433-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 N IRONWOOD CENTER DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142697",
            "telephone_number": "208-667-3585",
            "fax_number": "866-433-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER BUTLER DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-667-3585",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ID",
            "license": "P-195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807822600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.