Individual provider Active NPI

Kandice Butcher, PT

  • Physical Therapist
  • Dunkirk, NY
National Provider Identifier
1619923232
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008228 Issued in NY
Practice address
51 E 3Rd St
Dunkirk, NY 14048-2201
Phone
(716) 363-2244
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 008228 NY Primary

Addresses

Primary practice location

51 E 3Rd St
Dunkirk, NY 14048-2201

Mailing address

15 S Main St
Ste 220
Jamestown, NY 14701-6626
Phone (716) 488-2322

Other practice location 1

104 Memorial Dr
Gowanda, NY 14070-1111
Phone (716) 532-2258

Other identifiers 1

IdentifierTypeStateIssuer
J2101396318MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100521000012 NY Practitioner - Physical Therapist in Private Practice 6709879620
I20210726000419 GA Practitioner - Physical Therapist in Private Practice 6709879620 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanta Rehabilitation and Performance CenterGroup PAC ID 5890692917, 95 clinicians

Practice addresses (Care Compare)

1301 Sigman Rd NE
Suite 220
Conyers, GA 30012-3819
Phone (678) 210-0311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC CurrentSince Jun 15, 2021 Accepting new patients
The Chautauqua Center, Inc CurrentSince Oct 27, 2022 Accepting new patients
Resurgens, LLC CurrentSince Jun 15, 2021 Accepting new patients
Tri-County Physical Therapy, PC Physical Therapist Past Accepting new patients
Western New York PT Group PC Physical Therapist Past Accepting new patients
Rehabilitation Today Services for Psychology Et Al PLLC PastSince Sep 15, 2016 Accepting new patients

Locations

2041 Mesa Valley Way
Ste 100
Austell, GA 30106
Phone (770) 944-1100

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

51 E 3rd St
Dunkirk, NY 14048
Phone (716) 363-2244

1134 Central Ave
Dunkirk, NY 14048
Phone (716) 366-6036

15 S Main St
Ste 220
Jamestown, NY 14701
Phone (716) 484-4334

Organizations & group practices 8

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1619923232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST",
            "address_2": "STE 220",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016626",
            "telephone_number": "716-488-2322",
            "fax_number": "716-488-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 E 3RD ST",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140482201",
            "telephone_number": "716-363-2244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Gowanda",
            "state": "NY",
            "postal_code": "140701111",
            "country_code": "US",
            "telephone_number": "716-532-2258",
            "fax_number": "716-532-2321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTCHER",
        "first_name": "KANDICE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "008228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "J2101396318",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunkirk, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.