MR. JACK D BUTLER (NPI# 1316925449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316925449 |
| Entity Type | Individual |
| Full Name | MR. JACK D BUTLER |
| Credential | DO |
| Practice Address |
3300 Nw Expressway Oklahoma City OK 73112-4418 |
| Mailing Address |
5300 N Independence Ave Ste 280 Oklahoma City OK 73112-5556 |
| Practice Telephone | 4057137403 |
| Practice Fax Number | 4057132794 |
| Mailing Telephone | 4057137403 |
| Mailing Fax Number | 4057132794 |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2017-07-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 2084 | OK | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 1786 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 240010 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629594957 | Jack Butler | Driver | 5401 Pole Bridge Rd, Wise, VA 24293-4333 | 2017-08-18 |
| 1962491035 | Jack M. Butler | Emergency Medicine | 1504 Taub Loop, Houston, TX 77030-1608 | 2005-10-20 |
| Street Address |
3300 NW EXPRESSWAY |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73112-4418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578567848 | Gregory W Dinwiddie | Physician Assistant | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2005-06-02 |
| 1760083554 | Cristin Michelle Fong | Nurse Practitioner | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-11-06 |
| 1578160487 | Jennifer Bauman | Nurse Practitioner | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-10-04 |
| 1013525062 | Siera Alexis Freeman | Physical Therapist | 3300 Nw Expressway, Oklahoma City, OK 73112 | 2020-07-15 |
| 1447878152 | Sabrina Smith | Registered Nurse | 3300 Nw Expressway, Oklahoma City, OK 73112-4999 | 2020-07-09 |
| 1881219756 | Paul Rakowski | Emergency Medicine | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-06-16 |
| 1902429707 | Alex D Dumontier | Anesthesiologist Assistant | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-05-27 |
| 1417577305 | Oklahoma Emergency Physicians LLC | Emergency Medicine | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-04-21 |
| 1871113761 | Oklahoma Hospital Medicine Physicians LLC | Internal Medicine | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-04-21 |
| 1043839459 | Taylor Egbert | Student in an Organized Health Care Education/Training Program | 3300 Nw Expressway, Oklahoma City, OK 73112-4999 | 2020-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972145886 | Crystopher J Long | Physical Therapist | Parkway Post Acute Recovery Center, 6312 N Portland, Oklahoma City, OK 73112 | 2019-10-11 |
| 1700448974 | Joy Healthcare Services of Okc LLC | Home Health | 4200 Perimeter Center Drive, Suite 125, Oklahoma City, OK 73112 | 2019-07-08 |
| 1801380159 | Crysten Cheatwood Do, PC | Obstetrics & Gynecology | 3433 Nw 56 Street, Suite 210b, Oklahoma City, OK 73112 | 2018-06-20 |
| 1306352521 | Victoria Ann Kappel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3466 Nw 56th St. Suite 760, Oklahoma City, OK 73112 | 2017-12-26 |
| 1871014886 | Tanesia Michelle Smith | Case Management | 2629 W I44 Service Rd, Suite 202, Oklahoma City, OK 73112 | 2017-06-29 |
| 1619414257 | Edwige Gwanyama | Student in an Organized Health Care Education/Training Program | 2401 Nw 39 Th Expy Ste 103, Oklahoma City, OK 73112 | 2017-01-20 |
| 1619424017 | Jennifer Beaver | Peer Specialist | 2808 Nw 31st, Oklahoma City, OK 73112 | 2016-09-02 |
| 1417305368 | Gabriel Plank | Counselor | 3000 Founders Blvd Suite239, Oklahoma City, OK 73112 | 2016-06-01 |
| 1912364365 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 4101 N May Ave, Oklahoma City, OK 73112 | 2016-01-15 |
| 1679938922 | Portland Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | 5501 N Porland Ave, Oklahoma City, OK 73112 | 2015-12-30 |
| Find all providers in zip 73112 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083222038 | Miloni Mukesh Parmar | Internal Medicine | 800 Stanton L Young Blvd Aat 6300, Oklahoma City, OK 73104-5018 | 2020-07-16 |
| 1376181479 | Meraki Wellness Group, LLC | Internal Medicine | 1211 N Shartel Ave Ste 802, Oklahoma City, OK 73103-2425 | 2019-12-19 |
| 1447746417 | Nimrah Bader | Internal Medicine | 800 Stanton L. Young Blvd., Aat 6300, Oklahoma City, OK 73104 | 2018-07-02 |
| 1407349442 | Sarah Monther Nimri | Internal Medicine | 1200 Childrens Ave Ste 14046, Oklahoma City, OK 73104-4637 | 2018-06-13 |
| 1003343229 | Jesintha Stephenson | Internal Medicine | 800 Stanton L Young Blvd # 6300, Oklahoma City, OK 73104-5018 | 2017-05-18 |
| 1982149100 | Mary K Mercer | Internal Medicine | 5700 N Portland Ave Ste 102, Oklahoma City, OK 73112-1662 | 2016-12-24 |
| 1285087536 | Isma Nusrat Javed | Internal Medicine | 900 N Stonewall Ave Apt 86, C-20, Oklahoma City, OK 73117-2851 | 2016-07-21 |
| 1740632181 | Samid Muhammad Farooqui | Internal Medicine | 101 Ne 53rd St Apt 1917, Oklahoma City, OK 73105-1847 | 2016-07-11 |
| 1285082891 | Syeda Dania Shujaat | Internal Medicine | 920 Stanton L Young Blvd # Wp2040, Oklahoma City, OK 73104-5036 | 2016-05-25 |
| 1912352162 | Talal Zahoor | Internal Medicine | 505 E Sheridan Ave Apt 2141, Oklahoma City, OK 73104-6718 | 2016-04-25 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73112 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.