Butler and Brubaker Orthotics and Prosthetics

Primary specialty

ProsthetistTaxonomy code 224P00000X

Legal business name

BUTLER AND BRUBAKER ORTHOTICS AND PROSTHETICS

Practice address

10004 204TH Ave E Ste 3200
Bonney Lake, WA 98391-6539

Phone

(206) 790-3890

NPI assigned

Dec 18, 2019

Organization subpart

No

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

Authorized official

Name

Jacob Brubaker, CPONPI 1275880015

Title

Owner

Phone

(206) 790-3890

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob Robert Lynn Brubaker, C.P.O.

  • Prosthetist
  • Bonney Lake, WA
  • NPI 1275880015

  Orthotist

  NPD Authorized official
• Jeffery Durand Butler, CPED

  • Pedorthist
  • University Place, WA
  • NPI 1992660971
  NPD

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1699313742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 204TH AVE E STE 3200",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916539",
            "telephone_number": "206-790-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 204TH AVE E STE 3200",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916539",
            "telephone_number": "206-790-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTLER AND BRUBAKER ORTHOTICS AND PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-18",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "BRUBAKER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-790-3890",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Robert Lynn Brubaker, C.P.O.
• Nicole Michelle Bulldis-Frost, L.M.P.
• Suzanne C. Burgoyne, LMFT
• Lauren Burns
• Erin Butcher
• Samuel Joshua Cahn-Temes, LMT
• Stefany Jeneifer Cameron, PA-C
• Brandy Marre Campbell, OTR/L
• Anastacia M Candazo, LMT
• Kara Anne Cantrell, MA60930967

• Prosthetist in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Prosthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.