Heather Buckley, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5204 Issued in GA

Practice address

1400 Tullie Circle SE
Atlanta, GA 30329

Phone

(404) 785-1161

Fax

(404) 553-9789

NPI assigned

Nov 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Choa Multispecialty, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1437493467
  NPD (past)
• Pediatric Ear, Nose, & Throat of Atlanta, PC

  • Pediatric Otolaryngology Physician
  • Atlanta, GA
  • NPI 1134380017
  NPD (past)

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1083894539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 TULLIE CIRCLE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30329",
            "telephone_number": "404-785-1161",
            "fax_number": "404-553-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 TULLIE CIRCLE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30329",
            "telephone_number": "404-785-1161",
            "fax_number": "404-553-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "HEATHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "5204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1400 Tullie Circle SE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Buckhead Vision Inc
• Thomas H Buckingham
• Kevin Eugene Buckins, LPC
• Debi C Buckland, MS, LMFT, LPC
• Matthew Buckler, MD
• Kahsavyah Buckley
• Linda Buckley, LCSW
• Brenda A Buckner, NP
• Caroline Buckner
• Josephine Buclez

• Medical Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.