Individual provider Active NPI

Casey Scott Butterfield, DDS

  • General Practice Dentistry
  • Meridian, ID
National Provider Identifier
1720095003
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3806 Issued in ID
Practice address
2630 S Eagle Rd
Meridian, ID 83642-6704
Phone
(208) 888-0625
Fax
(208) 888-9128
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3806 ID Primary

Addresses

Primary practice location

2630 S Eagle Rd
Meridian, ID 83642-6704

Mailing address

2630 S Eagle Rd
Meridian, ID 83642-6704
Phone (208) 888-0625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150714000952 ID Order and Referring Only - DentistPractitioner - Dentist 3173836558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3806IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Stone Creek Dental General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720095003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 S EAGLE RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426704",
            "telephone_number": "208-888-0625",
            "fax_number": "208-888-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 S EAGLE RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426704",
            "telephone_number": "208-888-0625",
            "fax_number": "208-888-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTERFIELD",
        "first_name": "CASEY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "3806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.