Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michaela Sophia Butler, PA-S

Individual provider Physician Assistant · NPI 1457927204

Michaela Sophia Butler, PA-S is a Physician Assistant in Chubbuck, Idaho. Qualified in 2021, 5 years ago. Practices with Canvi Behavioral Health PLLC, a 13-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth.

Years since qualifying
5
In the registry since
2021

Practice location Address checks out

4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376
Phone: (208) 252-5621
Fax: (208) 648-4167
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 600 Pioneer Rd Apt 605, Rexburg, ID 83440-3790 — (208) 313-0422

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1457927204
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-S
Sole proprietorYes
NPI enumeratedJune 2, 2021
Last updated in NPPESMarch 21, 2022
Certification dateMarch 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Canvi Behavioral Health Pllc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Chubbuck