Individual provider Active NPI

Brent Meade Butler, PT, DPT

  • Physical Therapist
  • Elk Grove, CA
National Provider Identifier
1730435025
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19984 Issued in MA
Practice address
9280 W Stockton Blvd Ste 116
Elk Grove, CA 95758-8073
Phone
(916) 683-2580
Fax
(916) 683-1579
NPI assigned
Jul 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 19984 MA Primary

Addresses

Primary practice location

9280 W Stockton Blvd Ste 116
Elk Grove, CA 95758-8073

Mailing address

10470 Old Placerville Rd Ste 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170517000330 CA Practitioner - Physical Therapist in Private Practice 9537319744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

9280 W Stockton Blvd
Suite 116
Elk Grove, CA 95758-8073
Phone (916) 683-2580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince May 1, 2017 Accepting new patients
Sutter Valley Medical Foundation CurrentSince May 1, 2017 Accepting new patients
Joint Ventures Physical Therapy, Inc. Past Accepting new patients
Joint Ventures Physical Therapy, Inc. Physical Therapist PastSince May 16, 2019 Accepting new patients

Locations

9280 W Stockton Blvd
Ste 116
Elk Grove, CA 95758
Phone (916) 683-2580

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

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.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1730435025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9280 W STOCKTON BLVD STE 116",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588073",
            "telephone_number": "916-683-2580",
            "fax_number": "916-683-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "BRENT",
        "middle_name": "MEADE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "19984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.