Individual provider Active NPI

Myron Jamal Butts, D.C., LA.C

  • Chiropractor
  • Claremont, CA
National Provider Identifier
1972776961
Registry record updated Mar 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC30680 Issued in CA
Practice address
250 W 1St St
Suite#148
Claremont, CA 91711-4736
Phone
(562) 587-2065
Fax
(909) 622-9051
NPI assigned
Apr 10, 2008
Last updated
Mar 5, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC30680 CA Primary
Acupuncturist 171100000X AC 12860 CA

Addresses

Primary practice location

250 W 1St St
Suite#148
Claremont, CA 91711-4736

Mailing address

1102 Tonopah Ave.
La Puente, CA 91744
Phone (562) 587-2065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141001000717 CA Practitioner - Chiropractic 5597984906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4028 Long Beach Blvd
Suite 202
Long Beach, CA 90807-2697
Phone (562) 981-0555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30680CAMDClinical Psychologist
DC30680CAMDChiropractor
AC 12860CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Dunn Family Chiropractic Inc Chiropractor CurrentSince Oct 15, 2015 Accepting new patients
Pamela E. Dunn Chiropractic, Apc Chiropractor PastSince Dec 20, 2017 Accepting new patients

Locations

4028 Long Beach Blvd
Ste 202
Long Beach, CA 90807
Phone (562) 981-0555

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236211200000",
    "number": "1972776961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 TONOPAH AVE.",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "91744",
            "telephone_number": "562-587-2065",
            "fax_number": "909-622-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W 1ST ST",
            "address_2": "SUITE#148",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114736",
            "telephone_number": "562-587-2065",
            "fax_number": "909-622-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTS",
        "first_name": "MYRON",
        "middle_name": "JAMAL",
        "name_prefix": "Dr.",
        "credential": "D.C., LA.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2009-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC30680",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 12860",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.