NPIMap

Organization Active NPI

Dartmouth Medical Walk in PC III

  • Family Medicine Physician
  • North Dartmouth, MA
National Provider Identifier
1841268265
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
154055 Issued in MA
Legal business name
DARTMOUTH MEDICAL WALK IN PC III
Practice address
39 A Faunce Corner Road
Suite 2
North Dartmouth, MA 02747
Phone
(508) 996-3311
Fax
(508) 997-5352
NPI assigned
Mar 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephen Russell Butler, DONPI 1255318721
Title
President
Phone
(508) 996-3311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 154055 MA Primary

Addresses

Primary practice location

39 A Faunce Corner Road
Suite 2
North Dartmouth, MA 02747

Mailing address

39 A Faunce Corner Road
Suite 2
North Dartmouth, MA 02747
Phone (508) 996-3311

Other identifiers 1

IdentifierTypeStateIssuer
9703705MedicaidMA

National Provider Directory

National Provider Directory

Locations

39 Faunce Corner Rd
#2
North Dartmouth, MA 02747
Phone (508) 996-3311

39 Faunce Corner Rd
#A
North Dartmouth, MA 02747
Phone (508) 996-3311

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841268265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 A FAUNCE CORNER ROAD",
            "address_2": "SUITE 2",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "02747",
            "telephone_number": "508-996-3311",
            "fax_number": "508-997-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 A FAUNCE CORNER ROAD",
            "address_2": "SUITE 2",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "02747",
            "telephone_number": "508-996-3311",
            "fax_number": "508-997-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARTMOUTH MEDICAL WALK IN PC III",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-996-3311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "154055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9703705",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Dartmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.