Individual provider Active NPI

Mark Butanis, IDMT

  • Independent Duty Medical Technicians
  • Metairie, LA
National Provider Identifier
1710243126
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty Medical TechniciansTaxonomy code 1710I1003X
Practice address
3913 N I 10 Service Rd W Apt 239
Metairie, LA 70002-6828
Phone
(717) 659-3239
NPI assigned
Apr 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Medical Technicians 1710I1003X Primary

Addresses

Primary practice location

3913 N I 10 Service Rd W Apt 239
Metairie, LA 70002-6828

Mailing address

3913 N I 10 Service Rd W Apt 239
Metairie, LA 70002-6828
Phone (717) 659-3239

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

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1710243126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3913 N I 10 SERVICE RD W APT 239",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700026828",
            "telephone_number": "717-659-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3913 N I 10 SERVICE RD W APT 239",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700026828",
            "telephone_number": "717-659-3239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTANIS",
        "first_name": "MARK",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.