Active NPI
Logan R Butler, MD
- Surgery Physician
- Royal Oak, MI
National Provider Identifier
1477246320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 4351051208
- Practice address
- 3601 W 13 Mile Rd Ofc
Royal Oak, MI 48073-6712 - Phone
- (248) 551-3000
- NPI assigned
- May 29, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4351051208 | MI | Primary |
Addresses
Primary practice location
3601 W 13 Mile Rd Ofc
Royal Oak, MI 48073-6712
Mailing address
3601 W 13 Mile Rd Ofc
Royal Oak, MI 48073-6712
Phone (919) 356-7537
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230612001851 | MI | Order and Referring Only - General Surgery | 9638536303 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4351051208 | MI | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685318400000",
"number": "1477246320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 W 13 MILE RD OFC",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736712",
"telephone_number": "919-356-7537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 W 13 MILE RD OFC",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736712",
"telephone_number": "248-551-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "LOGAN",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-29",
"last_updated": "2023-05-29",
"certification_date": "2023-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4351051208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.