NPIMap

Individual provider Active NPI

Demsie M Butler, MD

  • Family Medicine Physician
  • Jerome, ID
National Provider Identifier
1457098386
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-17642 Issued in ID
Practice address
132 5TH Ave W Ste 1&2
Jerome, ID 83338-1871
Phone
(208) 814-9800
Fax
(208) 933-9648
NPI assigned
May 12, 2022
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M-17642 ID Primary
Family Medicine Physician 207Q00000X MRM-2141 ID

Addresses

Primary practice location

132 5TH Ave W Ste 1&2
Jerome, ID 83338-1871

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

132 5th Ave W Ste 1
Jerome, ID 83338-1825
Phone (208) 814-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250827003197 ID Practitioner - Family Practice 0042690687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

132 5TH Ave W
Suite 1/2
Jerome, ID 83338-1825
Phone (208) 814-9800

746 N College Rd
Twin Falls, ID 83301-3486

775 Pole Line Rd W
Twin Falls, ID 83301-5814
Phone (208) 814-1500

775 Pole Line Rd W
Twin Falls, ID 83301-5819

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-17642IDMDFamily Medicine Physician
MRM-2141IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Clinic LLC Family Medicine CurrentSince Aug 12, 2025 Accepting new patients
St Luke's Magic Valley Regional Medical Center LTD PastSince May 1, 2022 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

132 5th Ave W
Ste 1
Jerome, ID 83338
Phone (208) 814-9800

132 5th Ave W
Ste 12
Jerome, ID 83338
Phone (208) 814-9800

132 5th Ave W
Ste 2
Jerome, ID 83338
Phone (208) 324-5286

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1457098386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 5TH AVE W STE 1&2",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833381871",
            "telephone_number": "208-814-9800",
            "fax_number": "208-933-9648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "132 5th Ave W Ste 1",
            "address_purpose": "LOCATION",
            "city": "Jerome",
            "state": "ID",
            "postal_code": "833381825",
            "country_code": "US",
            "telephone_number": "208-814-9800",
            "fax_number": "208-933-9651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "DEMSIE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-17642",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MRM-2141",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jerome, ID

Sources for this page

Verify at the official NPI Registry.