Reilly Lyn Butler, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601010476 Issued in MI

Practice address

1325 E Sherman Blvd
Norton Shores, MI 49444-1813

Phone

(231) 737-8446

Fax

(231) 737-0510

NPI assigned

Aug 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: rbutler1524670@direct.trinity-health.org
• Direct secure messaging: lifewithoutlimits@micromddirect.com

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.

• Brian Gluck D.O., P.C.

  • Surgery Physician
  • Muskegon, MI
  • NPI 1588708820

  MI

  Medicare reassignment

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1932873262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E SHERMAN BLVD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494441813",
            "telephone_number": "231-737-8446",
            "fax_number": "231-737-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E SHERMAN BLVD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494441813",
            "telephone_number": "231-737-8446",
            "fax_number": "231-737-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "REILLY",
        "middle_name": "LYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marley Catherine Brust
• Timothy Jon Buning, MA, LPC CAADC
• Alexis Marti Burkhardt, DC
• Steven S. Burmeister, O.D.
• Mindy Michelle Burza, COTA/L
• Lauren Lyn Califf, LMSW
• Cara C Camp, MA
• Cancer & Hematology Centers of Western Mi, P.C.
• Cara C. Camp, LLC
• Curtis Cardon, D.D.S.

• All providers in Norton Shores, MI
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.