Individual provider Active NPI

Jonathan D Buckman, MSW

  • Clinical Social Worker
  • Saline, MI
National Provider Identifier
1063290849
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801099952 Issued in MI
Practice address
196 S Industrial Dr
Saline, MI 48176-9175
Phone
(734) 944-3446
Fax
(734) 316-2093
NPI assigned
Sep 21, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801099952 MI Primary

Addresses

Primary practice location

196 S Industrial Dr
Saline, MI 48176-9175

Mailing address

196 S Industrial Dr
Saline, MI 48176-9175
Phone (734) 944-3446

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
6801099952MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1063290849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 S INDUSTRIAL DR",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481769175",
            "telephone_number": "734-944-3446",
            "fax_number": "734-316-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 S INDUSTRIAL DR",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481769175",
            "telephone_number": "734-944-3446",
            "fax_number": "734-316-2093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKMAN",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801099952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saline, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.