Koby J Buth, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4351050718 Issued in MI

Practice address

230 W Oak St
Fremont, MI 49412-1526

Phone

(231) 924-4200

NPI assigned

Apr 18, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Western Michigan Un Homer Stryker School of Med, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: kbuth2737958@direct.trinity-health.org

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Mary'S Health Services

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1992492292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W OAK ST",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494121526",
            "telephone_number": "231-924-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTH",
        "first_name": "KOBY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-18",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351050718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "230 W Oak St",
            "city": "Fremont",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494121526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbuth1747302@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "230 W Oak St",
            "city": "Fremont",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494121526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer M Boyd, DDS
• Rebecca Joy Bruins, PA
• Lisa G Brummel, RPH
• Tianna Lynn Burns, C.O.T.A
• Stacey Butch, PHARMD
• Jeffrey B Byland, O.D.
• C & C Optical Shop Inc.
• Michael Peter Campeau, DDS
• John William Carlson Jr., RPH
• Chad Carpenter

• All providers in Fremont, MI
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.
• 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.