NPIMap

Individual provider Active NPI

Dawn Lynette Butts, O.D.

  • Optometrist
  • Madison, WI
National Provider Identifier
1619230638
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3265-35 Issued in WI
Practice address
4208 E Washington Ave
Madison, WI 53704
Phone
(608) 249-0667
Fax
(608) 249-2093
NPI assigned
Jun 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3265-35 WI Primary

Addresses

Primary practice location

4208 E Washington Ave
Madison, WI 53704

Mailing address

4208 E Washington Ave
Madison, WI 53704
Phone (608) 249-0667

Other names 1

  • Mrs. Dawn Lynette Tank Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3265-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyemart Express LLC Past Accepting new patients
Lincoln Physical Therapy and Sports Rehab LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1619230638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53704",
            "telephone_number": "608-249-0667",
            "fax_number": "608-249-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53704",
            "telephone_number": "608-249-0667",
            "fax_number": "608-249-2093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTS",
        "first_name": "DAWN",
        "middle_name": "LYNETTE",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3265-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "TANK",
            "middle_name": "LYNETTE",
            "prefix": "MRS.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.