Nicole Buckley

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA.18765-NP Issued in OH

Practice address

11706 Clifton Blvd
Lakewood, OH 44107-2018

Phone

(216) 228-9296

NPI assigned

Mar 14, 2016

Sex

Female

Sole proprietor

No

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 OH

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Diagnostic of Ohio LLC 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (2 of 6)

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

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.

• Minuteclinic Diagnostic of Ohio LLC

  • Family Nurse Practitioner
  • Hilliard, OH
  • NPI 1699747303

  Family, OH

  Medicare reassignment Care Compare group NPD
• Minuteclinic Primary Care Ohio LLC

  • Family Nurse Practitioner
  • Hilliard, OH
  • NPI 1285441766

  Family, OH

  Medicare reassignment NPD

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1033570346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16514 MUNN RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441112065",
            "telephone_number": "440-364-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11706 CLIFTON BLVD",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072018",
            "telephone_number": "216-228-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.18765-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Bryant, STNA
• Brye Roth LLC
• Diana Brzoza
• Nicole Marie Buado
• Philip Buck, L.I.S.W.
• David A Budny, D.C.
• Janice Buildt
• Emily Bunch
• Robert Alan Burke
• Kevin Burroughs, DC

• All providers in Lakewood, OH
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.