Individual provider Active NPI

William Barnes Butt, MD

  • Diagnostic Radiology Physician
  • Cartersville, GA
National Provider Identifier
1689623589
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
031215 Issued in GA
Practice address
10 Bowen CT
Cartersville, GA 30120-2494
Phone
(678) 928-9759
Fax
(678) 928-9759
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 031215 GA Primary

Addresses

Primary practice location

10 Bowen CT
Cartersville, GA 30120-2494

Mailing address

PO Box 200096
Cartersville, GA 30120-9002
Phone (678) 928-9759

Other identifiers 1

IdentifierTypeStateIssuer
000503632MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20050930000183 GA Practitioner - Diagnostic Radiology 1456242924

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aylo Health, LLC Past Accepting new patients
Optimal Readings Professional Services, LLC Diagnostic Radiology Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Tanner Medical Group Inc PastSince Jun 1, 2022 Accepting new patients

Organizations & group practices 4

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1689623589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200096",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301209002",
            "telephone_number": "678-928-9759",
            "fax_number": "678-928-9759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BOWEN CT",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202494",
            "telephone_number": "678-928-9759",
            "fax_number": "678-928-9759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTT",
        "first_name": "WILLIAM",
        "middle_name": "BARNES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "031215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000503632",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

Verify at the official NPI Registry.