NPIMap

Individual provider Active NPI

Jessica Buckley, CNP

  • Family Nurse Practitioner
  • Rapid City, SD
National Provider Identifier
1013731280
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP003448 Issued in SD
Practice address
350 Pine St
Rapid City, SD 57701-1669
Phone
(605) 721-8939
Fax
(605) 721-8998
NPI assigned
Nov 13, 2024
Last updated
Feb 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP003448 SD Primary
Primary Care Nurse Practitioner 363LP2300X CP003448 SD

Addresses

Primary practice location

350 Pine St
Rapid City, SD 57701-1669

Mailing address

350 Pine St
Rapid City, SD 57701-1669
Phone (605) 721-8939

Other practice location 1

217 Kansas City St Ste 200
Rapid City, SD 57701-3012
Phone (605) 721-8939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241216000471 SD Practitioner - Nurse Practitioner 4587190400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Center of the Black Hills IncGroup PAC ID 7618886334, 12 clinicians

Practice addresses (Care Compare)

350 Pine St
Rapid City, SD 57701-1669
Phone (605) 721-8939

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of the Black Hills Inc CurrentSince Dec 3, 2024 Accepting new patients
Community Health Center of the Black Hills, Inc Past Accepting new patients

Locations

10 Van Buren St
Rapid City, SD 57701
Phone (605) 721-8939

217 Kansas City St
Ste 200
Rapid City, SD 57701
Phone (605) 721-8939

350 Pine St
Rapid City, SD 57701
Phone (605) 721-8939

Interoperability endpoints

  • Direct secure messaging: jessica.buckley.1@32387.direct.athenahealth.com

Organizations & group practices 2

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

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1013731280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PINE ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011669",
            "telephone_number": "605-721-8939",
            "fax_number": "605-721-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PINE ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011669",
            "telephone_number": "605-721-8939",
            "fax_number": "605-721-8998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 Kansas City St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577013012",
            "country_code": "US",
            "telephone_number": "605-721-8939",
            "fax_number": "605-721-8998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "JESSICA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP003448",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "SD",
            "license": "CP003448",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.