Individual provider Active NPI

Greene Butler, M.D.

  • Surgery Physician
  • Ruston, LA
National Provider Identifier
1619947629
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
16316 Issued in LA
Practice address
1200 S Farmerville St
Ruston, LA 71270-5941
Phone
(318) 255-3690
NPI assigned
Jan 23, 2006
Last updated
Oct 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 16316 LA Primary

Addresses

Primary practice location

1200 S Farmerville St
Ruston, LA 71270-5941

Mailing address

1200 S Farmerville St
Ruston, LA 71270-5941
Phone (318) 255-3690

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100330001374 LA Practitioner - General Surgery 8022083971 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16316LAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lasalle Parish Hospital Service District #1 CurrentSince Jul 5, 2011 Accepting new patients
Lasalle Parish Hospital Service District #1 CurrentSince Jul 5, 2011 Accepting new patients
Green Clinic LLC CurrentSince Jul 1, 1986 Accepting new patients
Green Clinic LLC CurrentSince Jul 1, 1986 Accepting new patients
Lasalle Parish Hospital Service Dist No1 Past Accepting new patients
Green Clinic Surgical Hospital, LLC PastSince Jul 1, 2006 Accepting new patients
Lasalle Parish Hospital Service District #1 Past Accepting new patients

Locations

1049 N Pine Rd
Olla, LA 71465
Phone (318) 495-3175

1102 N Pine Rd
Olla, LA 71465
Phone (318) 495-5302

1200 S Farmerville St
Ruston, LA 71270
Phone (318) 251-6103

411 E Vaughn Ave
Ste 201
Ruston, LA 71270
Phone (318) 255-3223

Interoperability endpoints

  • Direct secure messaging: greene.butler@gcmc.directbygreenway.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255564800000",
    "number": "1619947629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705941",
            "telephone_number": "318-255-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705941",
            "telephone_number": "318-255-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "GREENE",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2009-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "16316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruston, LA

Sources for this page

Verify at the official NPI Registry.