Elliott Butler, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

000870 Issued in GA

Practice address

3400 McClure Bridge Rd
B201
Duluth, GA 30096-6675

Phone

(678) 957-8801

Fax

(678) 957-8804

NPI assigned

Nov 15, 2005

Last updated

Nov 24, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Butler Surgical Assistants, LLC

  • Surgical Physician Assistant
  • Watkinsville, GA
  • NPI 1629346325
  NPD Authorized official
• Surgical Assistants of America, Inc.

  • Surgery Physician
  • Duluth, GA
  • NPI 1417977885

  Surgical

  NPD (past)

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1619959756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3460",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300960059",
            "telephone_number": "678-957-8801",
            "fax_number": "678-957-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MCCLURE BRIDGE RD",
            "address_2": "B201",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300966675",
            "telephone_number": "678-957-8801",
            "fax_number": "678-957-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "ELLIOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "0044308",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "000870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER IDENTIFIER",
            "identifier": "1619959756",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I975412",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002796A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Ann Burroway, PT
• William Robert Burroway, PT
• Dewayne Burts, CDAC-I
• Liliana Buruca
• Business of Psychiatry and Strategy
• Rachel Butler
• Leatrice Byers
• Brandi Byler, PHARM D
• Lisa Marie Byrd, M.A., LPC
• Byung Yul Kim

• Surgical Physician Assistant in Duluth, GA
• Providers in Duluth, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.