{
"Npi": {
"NPI": "1275871485",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BUTT",
"FirstName": "AHMAR",
"MiddleName": "MANNAN",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "520 SPYGLASS CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WAUKEE",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "50263-8061",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "814-720-5669",
"MailingAddressFaxNumber": "515-282-8090",
"FirstLinePracticeLocationAddress": "1517 N ANKENY BLVD STE E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ANKENY",
"PracticeLocationAddressStateName": "IA",
"PracticeLocationAddressPostalCode": "50023-4120",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "515-337-3967",
"PracticeLocationAddressFaxNumber": "800-861-7495",
"EnumerationDate": "01/22/2013",
"LastUpdateDate": "09/10/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2084A0401X",
"TaxonomyName": "Addiction Medicine (Psychiatry & Neurology) Physician",
"LicenseNumber": "MD-42473",
"LicenseNumberStateCode": "IA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2084P0800X",
"TaxonomyName": "Psychiatry Physician",
"LicenseNumber": "272034",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2084P0804X",
"TaxonomyName": "Child & Adolescent Psychiatry Physician",
"LicenseNumber": "MD-42473",
"LicenseNumberStateCode": "IA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "208M00000X",
"TaxonomyName": "Hospitalist Physician",
"LicenseNumber": "MD-42473",
"LicenseNumberStateCode": "IA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2084P0800X",
"TaxonomyName": "Psychiatry Physician",
"LicenseNumber": "MD-42473",
"LicenseNumberStateCode": "IA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}