Individual provider Active NPI

Christina Marie Butler, M.D.

  • Pediatrics Physician
  • Corbin, KY
National Provider Identifier
1972775559
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
41670 Issued in KY
Practice address
57 Summit Dr
Corbin, KY 40701-2746
Phone
(606) 528-9700
Fax
(606) 528-8423
NPI assigned
Mar 24, 2008
Last updated
Sep 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 41670 KY Primary

Addresses

Primary practice location

57 Summit Dr
Corbin, KY 40701-2746

Mailing address

57 Summit Dr
Corbin, KY 40701-2746
Phone (606) 528-9700

Other identifiers 1

IdentifierTypeStateIssuer
7100043410MedicaidKY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081114000015 KY Practitioner - Pediatric Medicine 6406916964 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Community Health Center, Inc. CurrentSince Apr 1, 2023 Accepting new patients
Grace Community Health Center, Inc. CurrentSince Apr 1, 2023 Accepting new patients
Corbin Pediatric Associates PSC Pediatrics CurrentSince Apr 29, 2015 Accepting new patients

Locations

1019 Cumberland Falls Hwy
Ste B201
Corbin, KY 40701

14662 N US Highway 25 E
Corbin, KY 40701
Phone (606) 526-9005

57 Summit Dr
Corbin, KY 40701
Phone (606) 528-9700

60 Bryan Blvd
Ste 200
Corbin, KY 40701
Phone (606) 528-9700

39 Cumberland Gap Plz
Gray, KY 40734
Phone (606) 526-9005

313 S Cherry St
Pineville, KY 40977
Phone (606) 654-3338

Interoperability endpoints

  • Direct secure messaging: cbutler704281@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1972775559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 SUMMIT DR",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012746",
            "telephone_number": "606-528-9700",
            "fax_number": "606-528-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 SUMMIT DR",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012746",
            "telephone_number": "606-528-9700",
            "fax_number": "606-528-8423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-24",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "41670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100043410",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.