Ebonique Martin Buckner, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903424 Issued in MS

Practice address

768 Avery Blvd N
Ridgeland, MS 39157-5219

Phone

(601) 487-6482

NPI assigned

Sep 10, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quinn Healthcare,PLLCGroup PAC ID 6204802796, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adoration Home Health Home health agency, Vicksburg, MS, CCN 257103

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Quinn Healthcare,PLLC

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1821103920
  Medicare reassignment Care Compare group NPD
• Quinn Wellness

  • Family Medicine Physician
  • Terry, MS
  • NPI 1396502589
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Mississippi, LLC

  • Home Health Agency
  • Vicksburg, MS
  • NPI 1245288943
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1003465352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 AVERY BLVD N",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575219",
            "telephone_number": "601-487-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 AVERY BLVD N",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575219",
            "telephone_number": "601-487-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "EBONIQUE",
        "middle_name": "MARTIN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Anne Bryant, PT
• Lisa Deeann Bryant, PT, DPT, CEAS
• Mollie Z Buchanan, OT
• Randee Scheree Buchanan, OTR/L
• Mark Buckley, OT
• Kurt A Buechler, M.D.
• Rebecca Susan Bullock, SLP
• Renie Bumpous, PT
• Matthew Miller Burchfield, PHARMD
• Sarah Porter Burke, SLP

• Family Nurse Practitioner in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.