Individual provider Active NPI

Jennifer Lynn Butler, MD

  • Emergency Medicine Physician
  • Springfield, IL
National Provider Identifier
1710545520
Registry record updated Jul 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125073647 Issued in IL
Practice address
701 N 1St St
Springfield, IL 62781-3757
Phone
(217) 788-3000
Fax
(217) 788-3156
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036.159635 IL
Emergency Medicine Physician 207P00000X 125073647 IL Primary

Addresses

Primary practice location

701 N 1St St
Springfield, IL 62781-3757

Mailing address

701 N First Street Mid-America Emergency Physicians
Springfield, IL 62781-0001
Phone (217) 788-3156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220613002422 IL Practitioner - Emergency Medicine 7315272614 Reassigns benefits to 2 organizations
I20240819003812 AZ Practitioner - Emergency Medicine 7315272614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Colorado School of Medicine, Aurora, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ies Arizona PLLCGroup PAC ID 7810382884, 49 clinicians

Practice addresses (Care Compare)

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (520) 327-5461

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.68 of 100Reported as group
Quality
92.69
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.159635ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Passavant Memorial Area Hospital Association CurrentSince Nov 2, 2023 Accepting new patients
Ies Arizona PLLC Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Passavant Memorial Area Hospital Association Family Medicine Current Accepting new patients
Midwest Emergency Department Specialists LTD Emergency Medicine CurrentSince Jun 1, 2022 Accepting new patients

Locations

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

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.

Hospital & facility affiliations 1

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": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657324800000",
    "number": "1710545520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N FIRST STREET MID-AMERICA EMERGENCY PHYSICIANS",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627810001",
            "telephone_number": "217-788-3156",
            "fax_number": "217-788-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627813757",
            "telephone_number": "217-788-3000",
            "fax_number": "217-788-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2022-07-09",
        "certification_date": "2022-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.159635",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125073647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.