Individual provider Active NPI

John Butler, MD

  • Family Medicine Physician
  • Shelton, WA
National Provider Identifier
1851387633
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00015306 Issued in WA
Practice address
939 Mt View Dr
Suite #100
Shelton, WA 98584-4410
Phone
(360) 426-2653
Fax
(360) 432-3586
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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 MD00015306 WA Primary

Addresses

Primary practice location

939 Mt View Dr
Suite #100
Shelton, WA 98584-4410

Mailing address

939 Mt View Dr
Suite #100
Shelton, WA 98584-4410
Phone (360) 426-2653

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

State licenses

LicenseStateTypeSpecialty
MD00015306WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1851387633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 MT VIEW DR",
            "address_2": "SUITE #100",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844410",
            "telephone_number": "360-426-2653",
            "fax_number": "360-432-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 MT VIEW DR",
            "address_2": "SUITE #100",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844410",
            "telephone_number": "360-426-2653",
            "fax_number": "360-432-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00015306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.