DR. JEROME MACK BUTLER JR. (NPI# 1346425055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346425055 |
| Entity Type | Individual |
| Full Name | DR. JEROME MACK BUTLER JR. |
| Credential | M.D. |
| Practice Address |
2525 Court Dr Gastonia NC 28054-2140 |
| Mailing Address |
200 Queens Rd Suite 400 Charlotte NC 28204-3253 |
| Practice Telephone | 7048342944 |
| Mailing Telephone | 7043337376 |
| Mailing Fax Number | 7043333397 |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2018-07-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
2006-01706 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5908709 | 05 | |
| SC | N01706 | 05 | |
| NC | MEDCOST | 205202 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 Blythe Blvd, Suite 3809, Charlotte, NC 282035812 | 7043337376 | 7043333397 |
| Street Address |
2525 COURT DR |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054-2140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588664098 | Philip George Leone | Specialist | 2525 Court Dr, Gastonia, NC 28054-2140 | 2005-07-26 |
| 1124657564 | Jessica Underwood | Registered Nurse | 2525 Court Dr, Gastonia, NC 28054-2140 | 2020-04-07 |
| 1376182055 | Haley Noelle Devoe | Nurse Anesthetist, Certified Registered | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-12-30 |
| 1376182261 | Nicole Ruth Ann Bolt | Nurse Anesthetist, Certified Registered | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-12-26 |
| 1902441082 | Brennan Yett | Registered Nurse | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-11-12 |
| 1427692227 | Kara P Wilson | Nurse Anesthetist, Certified Registered | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-11-05 |
| 1568013233 | Rebecca Tooley Woodring | Physical Therapist | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-09-24 |
| 1730734989 | Rachel Carnicelli | Physician Assistant | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-08-05 |
| 1477113090 | Mckenzie Bolin Phillips | Nurse Practitioner | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-06-17 |
| 1528623840 | David Salter | Emergency Medicine | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-05-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871552778 | Robert M. Doline | Radiology | 2525 Court Dr, Gastonia, NC 28054-2140 | 2006-03-20 |
| 1881653855 | Charles J. Meakin | Radiology | 2525 Court Dr, Gastonia, NC 28054-2140 | 2006-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396121745 | Orit Kaidar - Person | Radiology | 101 Manning Drive, Cb #7512, Radiation Oncology, Chapel Hill, NC 27599-7512 | 2015-08-08 |
| 1134547201 | Zachary J Reitman | Radiology | 2301 Erwin Rd Duke University Hospital, Durham, NC 27710 | 2014-04-04 |
| 1861810756 | Susan Gr Mcduff | Radiology | Dumc 20 Duke Medical Center, Durham, NC 27710-0001 | 2014-03-28 |
| 1679830699 | Colette Joan Shen | Radiology | 101 Manning Drive Cb 7512, Chapel Hill, NC 27599-3307 | 2012-04-15 |
| 1124397328 | Aaron Tyler Wild | Radiology | 200 Queens Rd Ste 400, Charlotte, NC 28204-3264 | 2011-12-19 |
| 1891964615 | John William Nelson | Radiology | 5524 Hawthorne Park, Raleigh, NC 27613-6006 | 2008-02-26 |
| 1194905984 | Daniel G. Baseman | Radiology | 70 Neely Rd, Brevard, NC 28712-4267 | 2007-11-08 |
| 1285844183 | John S Moody | Radiology | 501 N. Elam Avenue, Greensboro, NC 27403 | 2007-05-22 |
| 1326251075 | North Carolina Oncology Associates | Radiology | 4101 Macon Pond Road, Raleigh, NC 27607-6319 | 2007-05-08 |
| 1164552865 | Christopher Ryan Kelsey | Radiology | Morris Building, Science Drive, Room 05135, Durham, NC 27710-0001 | 2007-03-06 |
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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.