NPIMap

Individual provider Active NPI

John Grant Buttram Jr., M.D.

  • Neurological Surgery Physician
  • Raleigh, NC
National Provider Identifier
1801019781
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
2008-00514 Issued in NC
Practice address
4207 Lake Boone TRL Ste 220
Raleigh, NC 27607-6685
Phone
(919) 784-1410
Fax
(919) 784-1409
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 2008-00514 NC Primary

Addresses

Primary practice location

4207 Lake Boone TRL Ste 220
Raleigh, NC 27607-6685

Mailing address

4207 Lake Boone TRL Ste 220
Raleigh, NC 27607-6685
Phone (919) 784-1410

Other practice location 1

5838 Six Forks Rd
Suite 100
Raleigh, NC 27609-3836
Phone (919) 785-3400

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Womens Clinic PA Current Accepting new patients
Rex Hospital, Inc. Past Accepting new patients
Rex Hospital Inc Past Accepting new patients
Rex Physicians LLC Neurological Surgery Past Accepting new patients
Raleigh Neurosurgical Clinic, Inc. Neurological Surgery Past Accepting new patients

Locations

102 Handley Park Ct
Goldsboro, NC 27534
Phone (919) 734-3344

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7773/brand/55/csg/581/fhir/r4

Organizations & group practices 5

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1801019781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 LAKE BOONE TRL STE 220",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076685",
            "telephone_number": "919-784-1410",
            "fax_number": "919-784-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 LAKE BOONE TRL STE 220",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076685",
            "telephone_number": "919-784-1410",
            "fax_number": "919-784-1409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5838 Six Forks Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276093836",
            "country_code": "US",
            "telephone_number": "919-785-3400",
            "fax_number": "919-783-7778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTTRAM",
        "first_name": "JOHN",
        "middle_name": "GRANT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NC",
            "license": "2008-00514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.