Individual provider Active NPI

Jacqueline Bowen Buford, APN

  • Family Nurse Practitioner
  • Bartlett, TN
National Provider Identifier
1093247801
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22366 Issued in TN
Practice address
6670 Stage Rd
Bartlett, TN 38134
Phone
(901) 384-9000
NPI assigned
Mar 30, 2017
Last updated
Jun 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22366 TN Primary

Addresses

Primary practice location

6670 Stage Rd
Bartlett, TN 38134

Mailing address

6670 Stage Rd
Bartlett, TN 38134-3810
Phone (901) 384-9000

Other identifiers 1

IdentifierTypeStateIssuer
13987984MedicaidTN

Other names 1

  • Mrs. Jacqueline Bowen Buford Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20170922001671 TN Practitioner - Nurse Practitioner 1456625896 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22366TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meharry Health Network, PC CurrentSince Nov 1, 2023 Accepting new patients
Prohealth Chiropractic LLC Past Accepting new patients

Locations

8400 NW 33rd St
Ste 201
Doral, FL 33122
Phone (786) 882-2869

1200 E Raines Rd
Ste 101
Memphis, TN 38116
Phone (663) 648-9448

438 N Cleveland St
Memphis, TN 38104
Phone (866) 364-8944

Interoperability endpoints

  • Direct secure messaging: jacqueline.buford@wwmp.eclinicaldirectplus.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1093247801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6670 STAGE RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381343810",
            "telephone_number": "901-384-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6670 STAGE RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "38134",
            "telephone_number": "901-384-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFORD",
        "first_name": "JACQUELINE",
        "middle_name": "BOWEN",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13987984",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "BUFORD",
            "middle_name": "BOWEN",
            "prefix": "MRS.",
            "credential": "APN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bartlett, TN

Sources for this page

Verify at the official NPI Registry.