Individual provider Active NPI

William I Buck, DPT

  • Physical Therapist
  • Berea, KY
National Provider Identifier
1053891200
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
007431 Issued in KY
Practice address
127 Clay Dr
Berea, KY 40403-1349
Phone
(859) 756-3281
Fax
(859) 756-3640
NPI assigned
Aug 17, 2018
Last updated
Apr 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 007431 KY Primary

Addresses

Primary practice location

127 Clay Dr
Berea, KY 40403-1349

Mailing address

330 Waller Ave Ste 275
Lexington, KY 40504-2930
Phone (859) 447-8600

Other practice location 1

998 S Highway 25 W
Williamsburg, KY 40769-1692
Phone (606) 539-7257

Other practice location 2

330 Waller Ave Ste 275
Lexington, KY 40504-2930
Phone (859) 447-8600

Other identifiers 1

IdentifierTypeStateIssuer
7100571180MedicaidKY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
007431KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Health System, Inc. PastSince Sep 9, 2018 Accepting new patients
PT Pros, Inc. Physical Therapist Past Accepting new patients
PT Solutions Holdings, LLC Physical Therapist Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1053891200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WALLER AVE STE 275",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042930",
            "telephone_number": "859-447-8600",
            "fax_number": "859-447-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 CLAY DR",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031349",
            "telephone_number": "859-756-3281",
            "fax_number": "859-756-3640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "998 S Highway 25 W",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "KY",
            "postal_code": "407691692",
            "country_code": "US",
            "telephone_number": "606-539-7257",
            "fax_number": "606-549-4900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Waller Ave Ste 275",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405042930",
            "country_code": "US",
            "telephone_number": "859-447-8600",
            "fax_number": "859-447-8599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCK",
        "first_name": "WILLIAM",
        "middle_name": "I",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-17",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "007431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100571180",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.