Active NPI
Alexandra Milloff Butler, MD
- Pediatrics Physician
- Portland, OR
National Provider Identifier
1770756595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD170971
- Practice address
- 2801 N Gantenbein Ave
Portland, OR 97227-1623 - Phone
- (503) 413-2042
- Fax
- (503) 413-2566
- NPI assigned
- Apr 13, 2008
- Last updated
- Mar 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME109315 | FL | |
| Pediatrics Physician | 208000000X | MD170971 | OR | Primary |
Addresses
Primary practice location
2801 N Gantenbein Ave
Portland, OR 97227-1623
Mailing address
PO Box 278
Woodburn, OR 97071-0278
Phone (971) 983-5260
Other practice location 1
342 Fairview St
Silverton, OR 97381-1917
Phone (503) 873-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003749200 | Medicaid | FL | |
| 500689081 | Medicaid | OR |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD170971 | OR | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1770756595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 278",
"city": "WOODBURN",
"state": "OR",
"postal_code": "970710278",
"telephone_number": "971-983-5260",
"fax_number": "971-983-5326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 N GANTENBEIN AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271623",
"telephone_number": "503-413-2042",
"fax_number": "503-413-2566"
}
],
"practiceLocations": [
{
"address_1": "342 Fairview St",
"address_purpose": "LOCATION",
"city": "Silverton",
"state": "OR",
"postal_code": "973811917",
"country_code": "US",
"telephone_number": "503-873-1500",
"fax_number": "503-873-1534",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUTLER",
"first_name": "ALEXANDRA",
"middle_name": "MILLOFF",
"name_prefix": "Ms.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-13",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME109315",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "MD170971",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003749200",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500689081",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.