Individual provider Active NPI

Henry King Butler Jr., MD

  • Dermatology Physician
  • Murfreesboro, TN
National Provider Identifier
1669485652
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD0000004757 Issued in TN
Practice address
515 Highland Terrace
Suite a
Murfreesboro, TN 37130-2423
Phone
(615) 890-0827
Fax
(615) 890-0828
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD0000004757 TN Primary

Addresses

Primary practice location

515 Highland Terrace
Suite a
Murfreesboro, TN 37130-2423

Mailing address

515 Highland Terrace
Suite a
Murfreesboro, TN 37130-2423
Phone (615) 890-0827

Other identifiers 2

IdentifierTypeStateIssuer
3163069MedicaidTN
P00133922OtherGARAILROAD MEDICARE

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000004757TNMDDermatology Physician
4757TNMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669485652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 HIGHLAND TERRACE",
            "address_2": "SUITE A",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371302423",
            "telephone_number": "615-890-0827",
            "fax_number": "615-890-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 HIGHLAND TERRACE",
            "address_2": "SUITE A",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371302423",
            "telephone_number": "615-890-0827",
            "fax_number": "615-890-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "HENRY",
        "middle_name": "KING",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "MD0000004757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3163069",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00133922",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.