Individual provider Active NPI

Nicole S Buuck

  • Specialist
  • Metairie, LA
National Provider Identifier
1033426168
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OTT.Z11509 Issued in LA
Practice address
608 Ridgewood Dr
Metairie, LA 70001-6128
Phone
(504) 309-8298
NPI assigned
Sep 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OTT.Z11509 LA Primary

Addresses

Primary practice location

608 Ridgewood Dr
Metairie, LA 70001-6128

Mailing address

608 Ridgewood Dr
Metairie, LA 70001-6128
Phone (504) 309-8298

Other names 1

  • Nicole Marie Surbeck Former name

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

LicenseStateTypeSpecialty
OTT.Z11509LAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1033426168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 RIDGEWOOD DR",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700016128",
            "telephone_number": "504-309-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 RIDGEWOOD DR",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700016128",
            "telephone_number": "504-309-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUUCK",
        "first_name": "NICOLE",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "OTT.Z11509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SURBECK",
            "middle_name": "MARIE",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.