Individual provider Active NPI

Luke Butters

  • Physician Assistant
  • Jackson, MI
National Provider Identifier
1720402605
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006944 Issued in MI
Practice address
100 E Michigan Ave
Jackson, MI 49201-1498
Phone
(517) 205-7766
Fax
(517) 205-7767
NPI assigned
Feb 12, 2014
Last updated
Mar 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601006944 MI Primary

Addresses

Primary practice location

100 E Michigan Ave
Jackson, MI 49201-1498

Mailing address

100 E Michigan Ave
Jackson, MI 49201-1498
Phone (517) 205-7766

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140609001029 MI Practitioner - Physician Assistant 6901020171 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601006944MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Eaton Hospital CurrentSince Aug 1, 2022 Accepting new patients
Prompt Care Express P.C. CurrentSince Oct 9, 2015 Accepting new patients
Sparrow Eaton Hospital CurrentSince Aug 1, 2022 Accepting new patients
W.a. Foote Memorial Hospital Physician Assistant CurrentSince Sep 1, 2015 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Aug 1, 2022 Accepting new patients
W.a. Foote Memorial Hospital Physician Assistant CurrentSince Sep 1, 2015 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

111 Lansing St
Ste 110
Charlotte, MI 48813
Phone (517) 541-5855

892 E Chicago St
Ste C
Coldwater, MI 49036
Phone (517) 278-2301

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

716 N Clippert St
Lansing, MI 48912
Phone (517) 253-4000

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Interoperability endpoints

  • Direct secure messaging: lbutters452801@direct.hfhs.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1720402605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011498",
            "telephone_number": "517-205-7766",
            "fax_number": "517-205-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011498",
            "telephone_number": "517-205-7766",
            "fax_number": "517-205-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTERS",
        "first_name": "LUKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-12",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.