Organization Active NPI

Dr. Butler & Associates, PLLC

  • Internal Medicine Physician
  • Paducah, KY
National Provider Identifier
1801928189
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29692 Issued in KY
Legal business name
DR. BUTLER & ASSOCIATES, PLLC
Practice address
2603 Kentucky Ave
Suite 303
Paducah, KY 42003-3814
Phone
(270) 443-2900
Fax
(270) 443-7122
NPI assigned
Mar 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Authorized official

Name
Mrs. Lori W. Butler
Title
Office Manager
Phone
(270) 443-2900

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 29692 KY Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA443 KY
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 2980P KY

Addresses

Primary practice location

2603 Kentucky Ave
Suite 303
Paducah, KY 42003-3814

Mailing address

PO Box 7626
Paducah, KY 42002-7626
Phone (270) 443-2900

Other identifiers 2

IdentifierTypeStateIssuer
65942161MedicaidKY
78904794MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040913000157 KY Part B Supplier - Clinic/Group Practice 6204803000 Receives reassigned benefits from 4 practitioners
Practice locations: La Center, KY; Wickliffe, KY; Paducah, KY

National Provider Directory

National Provider Directory

Locations

2603 Kentucky Ave
Ste 303
Paducah, KY 42003
Phone (270) 443-2900

134 Phillips Dr
Wickliffe, KY 42087
Phone (270) 335-3335

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1801928189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7626",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420027626",
            "telephone_number": "270-443-2900",
            "fax_number": "270-443-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 KENTUCKY AVE",
            "address_2": "SUITE 303",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033814",
            "telephone_number": "270-443-2900",
            "fax_number": "270-443-7122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BUTLER & ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "270-443-2900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "29692",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA443",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "2980P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65942161",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78904794",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.