Glenn A Butt, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

13870R Issued in LA

Practice address

2416 Hwy 435
Picayune, MS 39466

Phone

(769) 242-2525

Fax

(769) 272-2526

NPI assigned

Oct 5, 2006

Last updated

Aug 19, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Internal Medicine

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family First Healthcare ClinicGroup PAC ID 3971878190, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glenn.butt.1@16354.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/16354/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family First Healthcare Clinic

  • Clinic/Center
  • Picayune, MS
  • NPI 1962923573
  Medicare reassignment Care Compare group NPD
• Manna Ministries

  • Family Medicine Physician
  • Picayune, MS
  • NPI 1538863725
  NPD
• M a Culasso, LLC

  • Family Medicine Physician
  • Slidell, LA
  • NPI 1083617237
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1902992894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 HWY 435",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "39466",
            "telephone_number": "769-242-2525",
            "fax_number": "769-272-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 HWY 435",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "39466",
            "telephone_number": "769-242-2525",
            "fax_number": "769-272-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTT",
        "first_name": "GLENN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "13870R",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "17113",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1439959",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125336",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Gerard Boutte Jr., PHARMD
• Sara C Braddy, MOTR/L
• Jefferson Buntin, N.P.
• Jana B Burge
• Tiffany Burnette, APRN
• Jessica Byrd
• Jennifer F Cacioppo, FNP
• John H. Campbell, LCSW
• Caring Butterflies Homecare LLC
• Jose A Carlo, MD

• Internal Medicine Physician in Picayune, MS
• Providers in Picayune, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.