Individual provider Active NPI

Jeffrey P Butler, NP

  • Nurse Practitioner
  • Corbin, KY
National Provider Identifier
1922305796
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3006828 Issued in KY
Practice address
One Trillium Way
Baptist Regional Medical Center
Corbin, KY 40701-8420
Phone
(606) 528-1212
NPI assigned
Feb 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nurse Practitioner 363L00000X 3006828 KY Primary

Addresses

Primary practice location

One Trillium Way
Baptist Regional Medical Center
Corbin, KY 40701-8420

Mailing address

1431 Centerpoint Blvd
Suite 100
Knoxville, TN 37932-1984
Phone (865) 985-7068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110419000076 KY Practitioner - Nurse Practitioner 3476737354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1 Trillium Way
Corbin, KY 40701-8420
Phone (606) 528-1212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brock Medical, LLC Nurse Practitioner CurrentSince Jan 3, 2019 Accepting new patients
Southeastern Emergency Physicians LLC Nurse Practitioner CurrentSince Sep 1, 2021 Accepting new patients
Southeastern Emergency Services P C Nurse Practitioner CurrentSince Mar 7, 2011 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince Jan 3, 2019 Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

1649 Highway 192 W
London, KY 40741
Phone (606) 330-0055

239 N 12th St
Middlesboro, KY 40965
Phone (270) 632-1548

1431 Centerpoint Blvd
Ste 100
Knoxville, TN 37932
Phone (865) 539-8000

Organizations & group practices 4

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": "1297641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1922305796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 CENTERPOINT BLVD",
            "address_2": "SUITE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321984",
            "telephone_number": "865-985-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE TRILLIUM WAY",
            "address_2": "BAPTIST REGIONAL MEDICAL CENTER",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018420",
            "telephone_number": "606-528-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JEFFREY",
        "middle_name": "P",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-14",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3006828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.