Individual provider Active NPI

Abraham Renaldo Butler, MD

  • Family Medicine Physician
  • Macon, GA
National Provider Identifier
1851022578
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
104257 Issued in GA
Practice address
420 Charter Blvd Ste 402
Macon, GA 31210-0722
Phone
(478) 757-6400
NPI assigned
Jun 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 104257 GA Primary

Addresses

Primary practice location

420 Charter Blvd Ste 402
Macon, GA 31210-0722

Mailing address

420 Charter Blvd Ste 402
Macon, GA 31210-0722

Other practice location 1

1990 Holton Ave E Ofc
Big Stone Gap, VA 24219-3350
Phone (276) 679-4757

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250708004549 GA Practitioner - Family Practice 4486168812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

420 Charter Blvd
Suite 402
Macon, GA 31210-0722
Phone (478) 575-6500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
104257GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Medical Care Corporation Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Piedmont Providers LLC Past Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

420 Charter Blvd
Ste 402
Macon, GA 31210
Phone (478) 474-0394

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1851022578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 CHARTER BLVD STE 402",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312100722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 CHARTER BLVD STE 402",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312100722",
            "telephone_number": "478-757-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1990 Holton Ave E Ofc",
            "address_purpose": "LOCATION",
            "city": "Big Stone Gap",
            "state": "VA",
            "postal_code": "242193350",
            "country_code": "US",
            "telephone_number": "276-679-4757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "ABRAHAM",
        "middle_name": "RENALDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-22",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "104257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.