Active NPI
Cordaris Onassis Butler
- Community/Behavioral Health Agency
- Lawton, OK
National Provider Identifier
1699117796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- K083502495
- Practice address
- 2800 West Gore Blvd
Lawton, OK 73505 - Phone
- (318) 461-7954
- NPI assigned
- Jul 18, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | K083502495 | OK | Primary |
Addresses
Primary practice location
2800 West Gore Blvd
Lawton, OK 73505
Mailing address
2800 West Gore Blvd
Lawton, OK 73505
Phone (318) 461-7954
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K083502495 | OK | MD | Community/Behavioral Health Agency |
Interoperability endpoints
- cbutler66460@direct.utmsa.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374105600000",
"number": "1699117796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 WEST GORE BLVD",
"city": "LAWTON",
"state": "OK",
"postal_code": "73505",
"telephone_number": "318-461-7954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 WEST GORE BLVD",
"city": "LAWTON",
"state": "OK",
"postal_code": "73505",
"telephone_number": "318-461-7954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "CORDARIS",
"middle_name": "ONASSIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-18",
"last_updated": "2013-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "OK",
"license": "K083502495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.