NPIMap

Individual provider Active NPI

Lynn Butler, DO

  • Internal Medicine Physician
  • Elizabeth City, NC
National Provider Identifier
1700873486
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200600689 Issued in NC
Practice address
1805 W City Dr Ste H
Elizabeth City, NC 27909-9660
Phone
(252) 334-1602
Fax
(252) 334-1604
NPI assigned
Sep 29, 2005
Last updated
Nov 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200600689 NC Primary

Addresses

Primary practice location

1805 W City Dr Ste H
Elizabeth City, NC 27909-9660

Mailing address

PO Box 11314
Belfast, ME 04915-4004
Phone (757) 842-4481

Other practice location 1

100 Plank Bridge Rd
Camden, NC 27921-2792
Phone (252) 331-1929

Other practice location 2

1805 W City Dr
Elizabeth City, NC 27909-9646
Phone (252) 331-2937

Other practice location 3

1138 N Road St
Elizabeth City, NC 27909
Phone (252) 338-4117

Other identifiers 1

IdentifierTypeStateIssuer
200600689OtherNCSTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060831000315 NC Practitioner - Internal Medicine 5496701559 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rowan University School of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chesapeake Regional Medical GroupGroup PAC ID 8426113663, 148 clinicians

Practice addresses (Care Compare)

100 Plank Bridge Rd B
Camden, NC 27921-7640
Phone (252) 331-1829

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.57 of 100Reported as group
Quality
87.01
Promoting interoperability
100
Improvement activities
40
Cost
81.57

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200600689NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of North Carolina PLLC Internal Medicine CurrentSince Nov 1, 2015 Accepting new patients
Chesapeake Regional Medical Group CurrentSince Feb 1, 2018 Accepting new patients
Sound Physicians of North Carolina, PLLC Internal Medicine CurrentSince May 25, 2014 Accepting new patients
Chesapeake Regional Medical Group Internal Medicine CurrentSince Feb 1, 2018 Accepting new patients
Colon Rectal Surgery of Tidewater, P.C. Past Accepting new patients

Locations

100 Plank Bridge Rd Ct
Unit B
Camden, NC 27921
Phone (252) 331-1829

1805 W City Dr
Elizabeth City, NC 27909
Phone (252) 331-2937

1805 W City Dr
Ste H
Elizabeth City, NC 27909
Phone (252) 334-1602

1138 N Road St
Elizabeth Cty, NC 27909
Phone (252) 335-4890

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

534 Caratoke Hwy
Moyock, NC 27958
Phone (252) 435-6621

Interoperability endpoints

  • Direct secure messaging: lynn.butler.1@5072.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1700873486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11314",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154004",
            "telephone_number": "757-842-4481",
            "fax_number": "757-312-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 W CITY DR STE H",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279099660",
            "telephone_number": "252-334-1602",
            "fax_number": "252-334-1604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Plank Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NC",
            "postal_code": "279212792",
            "country_code": "US",
            "telephone_number": "252-331-1929",
            "fax_number": "252-331-2916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1805 W City Dr",
            "address_purpose": "LOCATION",
            "city": "Elizabeth City",
            "state": "NC",
            "postal_code": "279099646",
            "country_code": "US",
            "telephone_number": "252-331-2937",
            "fax_number": "252-331-2973",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1138 N Road St",
            "address_purpose": "LOCATION",
            "city": "Elizabeth City",
            "state": "NC",
            "postal_code": "27909",
            "country_code": "US",
            "telephone_number": "252-338-4117",
            "fax_number": "252-338-2087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200600689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "200600689",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

Verify at the official NPI Registry.