ANISSA C BUTLER MD
NPI 1962105593
Student in an Organized Health Care Education/Training Program in Santa Rosa, CA
About Anissa C Butler Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANISSA C BUTLER MD (NPI 1962105593) is an individual student in an organized health care education/training program in Santa Rosa, California and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Anissa C Butler Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SANTA ROSA, CA 95403
SANTA ROSA, CA 95403
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Anissa Butler's NPI number?
The NPI number for Anissa Butler is 1962105593. It was assigned to this individual provider in the NPPES registry on March 23, 2023.
Where is Anissa Butler located?
Anissa Butler practices at 401 Bicentennial Way, Santa Rosa, CA 95403. The listed phone number is (707) 393-4000.
What is Anissa Butler's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Anissa Butler enrolled in Medicare?
Yes. Anissa Butler is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Anissa Butler was last updated on March 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Anissa C Butler, MD · NPI 1962105593
Student in an Organized Health Care Education/Training Program provider in Santa Rosa, California. Individual provider, active in the CMS NPPES registry since March 23, 2023.
## Identity
- **NPI:** 1962105593 (Entity type: Individual)
- **Enumerated:** March 23, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 401 BICENTENNIAL WAY, Santa Rosa, CA 95403-2149
- **Phone:** (707) 393-4000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** March 23, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1962105593) · Data from the CMS NPPES public registry.