Active NPI
Jack Butterfield, M.D.
- Family Medicine Physician
- Roseville, OH
National Provider Identifier
1639154495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35045078
- Practice address
- 167 S Main St
Roseville, OH 43777-1284 - Phone
- (740) 697-7373
- Fax
- (740) 697-7683
- NPI assigned
- Dec 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35045078 | OH | Primary |
Addresses
Primary practice location
167 S Main St
Roseville, OH 43777-1284
Mailing address
860 Bethesda Dr
Zanesville, OH 43701-1800
Phone (740) 454-4651
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080002140 | Other | OH | MEDICARE RAILROAD |
| 000000019419 | Other | OH | ANTHEM PIN |
| CA1586 | Other | GROUP MEDICARE RAILROAD | |
| 0989499 | Other | OH | GROUP MEDICAID |
| 000000177535 | Other | OH | UNISON PIN |
| 311413469030 | Other | OH | CARESOURCE PIN |
| BU0499444 | Other | MEDICARE PTAN | |
| 0197989 | Other | OH | UHC PIN |
| 0437021 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35045078 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Muskingum County | Past | Accepting new patients |
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.
-
- Public Health or Welfare Agency
- Zanesville, OH
- NPI 1699892927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219104000000",
"number": "1639154495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "860 BETHESDA DR",
"city": "ZANESVILLE",
"state": "OH",
"postal_code": "437011800",
"telephone_number": "740-454-4651",
"fax_number": "740-454-4653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "167 S MAIN ST",
"city": "ROSEVILLE",
"state": "OH",
"postal_code": "437771284",
"telephone_number": "740-697-7373",
"fax_number": "740-697-7683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTTERFIELD",
"first_name": "JACK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-14",
"last_updated": "2008-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35045078",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "080002140",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PIN",
"identifier": "000000019419",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE RAILROAD",
"identifier": "CA1586",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICAID",
"identifier": "0989499",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON PIN",
"identifier": "000000177535",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE PIN",
"identifier": "311413469030",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "BU0499444",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC PIN",
"identifier": "0197989",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0437021",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roseville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.