Individual provider Active NPI

Bonnie L Butterfield, PT

  • Physical Therapist
  • South Portland, ME
National Provider Identifier
1861608762
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT628 Issued in ME
Practice address
105 Main St
South Portland, ME 04106-2621
Phone
(207) 741-2624
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT628 ME Primary

Addresses

Primary practice location

105 Main St
South Portland, ME 04106-2621

Mailing address

36 Green Trees Dr
Gorham, ME 04038-2278
Phone (207) 839-7025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260526003502 ME Practitioner - Physical Therapist in Private Practice 6305316829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services Me LLCGroup PAC ID 0042607681, 45 clinicians

Practice addresses (Care Compare)

Brunswick, ME 04011
Phone (877) 407-3422

Scarborough, ME 04074
Phone (877) 407-3422

Falmouth, ME 04105
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT628MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Certified Healthcare Corp Past Accepting new patients

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861608762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 GREEN TREES DR",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040382278",
            "telephone_number": "207-839-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MAIN ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062621",
            "telephone_number": "207-741-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTERFIELD",
        "first_name": "BONNIE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.