Kimberly E Buckley, RN

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

4704253097 Issued in MI

Practice address

15600 19 Mile Rd
Clinton TWP, MI 48038-3502

Phone

(586) 263-8688

NPI assigned

Mar 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1073148649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383502",
            "telephone_number": "586-263-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383502",
            "telephone_number": "586-263-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "KIMBERLY",
        "middle_name": "E",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "MI",
            "license": "4704253097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Michelle Brummett, LLC
• Jeffrey M Bruner, DO
• Sabrina Bruni, DPT
• Edwynn Bryant
• Eric Bryant
• Meadow Jane Bugamelli
• Daniel Thomas Bukacel Jr.
• Brian William Bunte, BSW, LBSW
• Norman Joseph Buss, RPH.
• Lois Michelle Butler-Jackson, MD, CWS

• Administrator Registered Nurse in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Administrator Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.