Organization Active NPI

Adam S. Butera MD PA

  • Psychiatry Physician
  • Wichita Falls, TX
National Provider Identifier
1992865992
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ADAM S. BUTERA MD PA
Practice address
1714 10TH St
Wichita Falls, TX 76301-5011
Phone
(940) 766-4482
Fax
(940) 766-4487
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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

Authorized official

Name
Adam S Butera, MDNPI 1376505545
Title
Owner
Phone
(940) 766-4482

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1714 10TH St
Wichita Falls, TX 76301-5011

Mailing address

1714 10TH St
Wichita Falls, TX 76301-5011
Phone (940) 766-4482

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090218000624 TX Part B Supplier - Clinic/Group Practice 6507961000 Receives reassigned benefits from 7 practitioners
Practice locations: Wichita Falls, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2036853Adam S Butera MD PA1714 10TH Street, Wichita Falls, TX 76301Certificate of waiverFeb 13, 2028

National Provider Directory

National Provider Directory

Locations

1714 10th St
Wichita Falls, TX 76301
Phone (940) 322-1075

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394409600000",
    "number": "1992865992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 10TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763015011",
            "telephone_number": "940-766-4482",
            "fax_number": "940-766-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 10TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763015011",
            "telephone_number": "940-766-4482",
            "fax_number": "940-766-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADAM S. BUTERA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2014-03-10",
        "status": "A",
        "authorized_official_last_name": "BUTERA",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-766-4482",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.