| Michaela Sophia Butler, PA-S | |
|
4650 Hawthorne Rd Ste 3b, Chubbuck, ID 83202-2376 | |
| (208) 252-5621 | |
| (208) 648-4167 |
| Full Name | Michaela Sophia Butler |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 5 Years |
| Location | 4650 Hawthorne Rd Ste 3b, Chubbuck, Idaho |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457927204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Canvi Behavioral Health Pllc | 0941692073 | 14 |
| Entity Name | Canvi Behavioral Health PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144984873 PECOS PAC ID: 0941692073 Enrollment ID: O20220121000627 |
| Mailing Address | Practice Location Address |
|---|---|
| Michaela Sophia Butler, PA-S 600 Pioneer Rd Apt 605, Rexburg, ID 83440-3790 Ph: Not Available | Michaela Sophia Butler, PA-S 4650 Hawthorne Rd Ste 3b, Chubbuck, ID 83202-2376 Ph: (208) 252-5621 |
Renee Lynn Katter, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 4460 Kings Way Ste 3, Chubbuck, ID 83202 Phone: 208-237-3612 Fax: 208-237-5192 |
Mitchel B Vellinga, CMA, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 880 W Quinn Rd, Chubbuck, ID 83202 Phone: 208-238-2000 |
Brookelle Smith Gunn, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 880 W Quinn Rd, Chubbuck, ID 83202 Phone: 208-238-2000 |
Mrs. Rachel M Koster, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4650 Hawthorne Road,, Suite 3b, Chubbuck, ID 83202 Phone: 208-237-9833 |
Mr. Wiley D Petersen, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 134 W Chubbuck Rd, Chubbuck, ID 83202 Phone: 208-417-0102 Fax: 208-242-3219 |
Ryan T Mcculloch, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 147 W Chubbuck Rd, Chubbuck, ID 83202 Phone: 208-238-7546 Fax: 208-237-9643 |
Brent Leavitt, Physician Assistant Medicare: Medicare Enrolled Practice Location: 4928 Pleasant View Dr, Chubbuck, ID 83202 Phone: 208-760-9416 |