Individual provider Active NPI

Connor James Butz, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1821654617
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
12729 Issued in GA
Practice address
659 Auburn Ave NE Ste 156
Atlanta, GA 30312-1976
Phone
(404) 888-0228
Fax
(833) 941-5100
NPI assigned
May 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X PA031613 DC
Medical Physician Assistant 363AM0700X 12729 GA Primary

Addresses

Primary practice location

659 Auburn Ave NE Ste 156
Atlanta, GA 30312-1976

Mailing address

659 Auburn Ave NE Ste 156
Atlanta, GA 30312-1976
Phone (404) 888-0228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20250227000591 GA Practitioner - Physician Assistant 1557796125 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA031613DCMDMedical Physician Assistant
12729GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: connor.butz.1@26356.direct.athenahealth.com

Organizations & group practices 2

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": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1821654617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 AUBURN AVE NE STE 156",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121976",
            "telephone_number": "404-888-0228",
            "fax_number": "833-941-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 AUBURN AVE NE STE 156",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121976",
            "telephone_number": "404-888-0228",
            "fax_number": "833-941-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTZ",
        "first_name": "CONNOR",
        "middle_name": "JAMES",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-16",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA031613",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "12729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.