Active NPI
Mandy D Buckley, CPHT
- Pharmacy Technician
- Jackson, TN
National Provider Identifier
1013068071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 17680
- Practice address
- 200 W Main St
Jackson, TN 38301-6114 - Phone
- (731) 427-1528
- Fax
- (731) 423-4590
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 17680 | TN | Primary |
Addresses
Primary practice location
200 W Main St
Jackson, TN 38301-6114
Mailing address
525 Smith Rd
Luray, TN 38352-1789
Phone (731) 983-0529
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17680 | TN | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013068071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 SMITH RD",
"city": "LURAY",
"state": "TN",
"postal_code": "383521789",
"telephone_number": "731-983-0529",
"fax_number": "731-423-4590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W MAIN ST",
"city": "JACKSON",
"state": "TN",
"postal_code": "383016114",
"telephone_number": "731-427-1528",
"fax_number": "731-423-4590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKLEY",
"first_name": "MANDY",
"middle_name": "D",
"credential": "CPHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "TN",
"license": "17680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.