Marvin Ray Butler, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

53193 Issued in CA

Practice address

542 Thunderbird Dr
Rogersville, MO 65742-9704

Phone

(813) 928-9743

NPI assigned

Jun 21, 2006

Last updated

Dec 12, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TX, NC2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hazel Hawkins Memorial HospitalGroup PAC ID 9133038326, shared by 8 NPIs, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Elizabeth Community Hospital Hospital, Red Bluff, CA, CCN 050042

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: marvin.butler.p1@direct.cdsdp.nextgenshare.com

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.

• Eagle Butte Indian Health Service Hospital

  • Public Health or Welfare Agency
  • Eagle Butte, SD
  • NPI 1558395848

  TX

  Medicare reassignment
• Hoke Emergency Group, PC

  • Emergency Medicine Physician
  • Raeford, NC
  • NPI 1003337528
  Medicare reassignment
• Tuba City Regional Health Care Corporation

  dba Tuba City Indian Medical Center

  • General Acute Care Hospital
  • Tuba City, AZ
  • NPI 1548294424

  TX

  Medicare reassignment
• Tuba City Regional Health Care Corporation

  dba Dinnebito Health Clinic

  • Family Medicine Physician
  • Kykotsmovi, AZ
  • NPI 1396921870
  NPD
• Tuba City Regional Health Care Corporation

  dba Bodaway Gap Clinic

  • Family Medicine Physician
  • Bodaway Gap, AZ
  • NPI 1710519913
  NPD

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

• Dignity Health

  dba St. Elizabeth Community Hospital

  • General Acute Care Hospital
  • Red Bluff, CA
  • NPI 1083732853
  Care Compare affiliation
• Dignity Health

  dba Dignity Health Solano Street Medical Clinic

  • Rural Health Clinic/Center
  • Corning, CA
  • NPI 1609246461

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1992741755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550643",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336550643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 THUNDERBIRD DR",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657429704",
            "telephone_number": "813-928-9743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "MARVIN",
        "middle_name": "RAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Marie Baker, PA-C
• Steven R Barnes, FNP
• Kimberly Bergmann
• Melissa L Bias, MS, PLPC
• Jessica Burks, FNP-C
• Clear Creek Family Dental Rogersville
• Jennifer Coffman
• James Willard Coker, PHARM.D.
• Lori Ann Cole, MS,OTR/L
• Stephanie Rose Davison, FNP-BC

• Physician Assistant in Rogersville, MO
• Providers in Rogersville, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.