Brock Buckner
Individual provider Active NPI Occupational Therapist · Pilot, VA
NPI 1013417229 · NPPES record last updated Feb 14, 2018
Key facts
- NPI
- 1013417229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 4915 (SC)
- Practice address
- 159 Oak Creek Lane
Pilot, VA 24138 - Phone
- (540) 320-9260
- NPI assigned
- Feb 14, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4915 | SC | Yes |
Addresses
Primary practice location
159 Oak Creek Lane
Pilot, VA 24138
Mailing address
159 Oak Creek Lane
Pilot, VA 24138
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4915 | Other | SC | SC OT LC |
Other providers in Pilot, VA
All providers in Pilot, VA · Occupational Therapist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.