Matt F Butryn, PHD, LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2503 Issued in GA

Legal business name

MATT F BUTRYN, PHD, LLC

Practice address

1 Huntington Rd
Suite 802
Athens, GA 30606-7204

Phone

(706) 548-0018

NPI assigned

May 10, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Matt F Butryn, PHDNPI 1639158868

Title

Practice Owner

Phone

(706) 548-0018

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Athens Neuropsychology and Counseling Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matt F Butryn, PH.D.

  • Clinical Neuropsychologist
  • Athens, GA
  • NPI 1639158868
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336608000000",
    "number": "1942569090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HUNTINGTON RD",
            "address_2": "SUITE 802",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306067204",
            "telephone_number": "706-548-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HUNTINGTON RD",
            "address_2": "SUITE 802",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306067204",
            "telephone_number": "706-548-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATT F BUTRYN, PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-05-10",
        "status": "A",
        "authorized_official_last_name": "BUTRYN",
        "authorized_official_first_name": "MATT",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "706-548-0018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "2503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000918222A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athens Neuropsychology and Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lucia Massey, IBCLC
• Rebecca Catherine Mastrodicasa, PT
• Jana Suzanne Mastrogiovanni, LPC
• Ranjit Cherian Mathew, M.D. PH.D
• Melanie Norton Mathis
• Kristin Anne Matt, CRNP
• Matthew McRae, D.M.D.,PC.
• Brooke Matthews
• James Kip Matthews, PH.D.
• Nicki Matthews

• Clinical Neuropsychologist in Athens, GA
• Providers in Athens, GA by specialty
• Clinical Neuropsychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.