Individual provider Active NPI

Olesya Alexandra Buck

  • Speech-Language Pathologist
  • Morgantown, WV
National Provider Identifier
1063941003
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1942 Issued in WV
Practice address
1129 Andrew Dr
Morgantown, WV 26508-6842
Phone
(917) 981-9203
NPI assigned
Jun 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 0707
Speech-Language Pathologist 235Z00000X 1942 WV Primary

Addresses

Primary practice location

1129 Andrew Dr
Morgantown, WV 26508-6842

Mailing address

1129 Andrew Dr
Morgantown, WV 26508-6842

Other practice location 1

255 Sunbridge Dr
Salem, WV 26426-8400
Phone (304) 782-3000

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
1942WVMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1063941003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 ANDREW DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265086842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 ANDREW DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265086842",
            "telephone_number": "917-981-9203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Sunbridge Dr",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "WV",
            "postal_code": "264268400",
            "country_code": "US",
            "telephone_number": "304-782-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCK",
        "first_name": "OLESYA",
        "middle_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "0707",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "1942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.