Active NPI
Tarry Adair Butner, P.T.
- Physical Therapist
- Oakland, MD
National Provider Identifier
1861579666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15636
- Practice address
- 13141 Garrett Hwy
Oakland, MD 21550-1164 - Phone
- (301) 334-5220
- Fax
- (301) 334-6277
- NPI assigned
- Nov 1, 2006
- Last updated
- Mar 20, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15636 | MD | Primary |
Addresses
Primary practice location
13141 Garrett Hwy
Oakland, MD 21550-1164
Mailing address
13141 Garrett Hwy
Oakland, MD 21550-1164
Phone (301) 334-5220
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 258607 | Other | MD | ALLIANCE/MD.IPA/OPTIMUM C |
| E273 0003 | Other | MD | GHMSI & BCBS FEERAL |
| 60405501 | Other | MD | CAREFIRST BCBS |
| 0158028000 | Medicaid | WV | |
| 11937 | Other | MD | PRIORITY PARTNERS |
| 15636 | Other | MD | LICENSE # |
| IWIF 25-99 | Other | MD | INJURED WORKERS' |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15636 | MD | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205971200000",
"number": "1861579666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13141 GARRETT HWY",
"city": "OAKLAND",
"state": "MD",
"postal_code": "215501164",
"telephone_number": "301-334-5220",
"fax_number": "301-334-6277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13141 GARRETT HWY",
"city": "OAKLAND",
"state": "MD",
"postal_code": "215501164",
"telephone_number": "301-334-5220",
"fax_number": "301-334-6277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTNER",
"first_name": "TARRY",
"middle_name": "ADAIR",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2008-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "15636",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIANCE/MD.IPA/OPTIMUM C",
"identifier": "258607",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHMSI & BCBS FEERAL",
"identifier": "E273 0003",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BCBS",
"identifier": "60405501",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0158028000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY PARTNERS",
"identifier": "11937",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "15636",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INJURED WORKERS'",
"identifier": "IWIF 25-99",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.