Wellcare Family Medicine PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN16901 Issued in TN

Legal business name

WELLCARE FAMILY MEDICINE PLLC

Doing business as

Angela Buckner

Practice address

517 Russell St
Suite C
Dunlap, TN 37327-3648

Phone

(423) 949-9355

Fax

(423) 949-9358

NPI assigned

Apr 11, 2017

Last updated

Apr 11, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angela Louise Buckner, APN

Title

Owner/Provider

Phone

(423) 949-9355

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Angela Buckner Doing business as

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15264/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1073046587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 RUSSELL ST",
            "address_2": "SUITE C",
            "city": "DUNLAP",
            "state": "TN",
            "postal_code": "373273648",
            "telephone_number": "423-949-9355",
            "fax_number": "423-949-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 RUSSELL ST",
            "address_2": "SUITE C",
            "city": "DUNLAP",
            "state": "TN",
            "postal_code": "373273648",
            "telephone_number": "423-949-9355",
            "fax_number": "423-949-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "423-949-9355",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN16901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1529434",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angela Buckner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexis K Turner, PTA
• Savannah Faith Turner, LPN
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• Walgreen Co (Walgreens #11670)
• Donna Kay Wright, APN-BC
• Diana Duke Yantis, PTA
• George Chalmers Young III, PHARMD

• Family Nurse Practitioner in Dunlap, TN
• Providers in Dunlap, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.