Richard Butler, D.O. – Internal Medicine Physician

Key facts

NPI: 1477544799
Entity type: Individual (NPI type 1)
Primary specialty: Internal Medicine Physician 207R00000X
License: 0102-201770 (VA)
Practice address: 1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone: (540) 981-7000
NPI assigned: Nov 4, 2005
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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

St John Oakland Hospital General Acute Care Hospital · Warren, MI · NPI 1942271671

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Osteopathy

State licenses

License	State	Type	Specialty
0102-201770	VA	MD	Internal Medicine Physician

Practice roles

Organization	Specialty	Status	New patients
St John Oakland Hospital		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician	207R00000X	0102-201770	VA	Yes

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

8135 Vista Forest Dr
Roanoke, VA 24018-5714

Other identifiers

Identifier	Type	State	Issuer
010185602	Medicaid	VA
010185637	Medicaid	VA

Other providers in Roanoke, VA

All providers in Roanoke, VA · Internal Medicine Physician in Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.