Virginia Ann Buccola, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP60296557 Issued in WA

Practice address

1202 MLK Jr Way
Tacoma, WA 98405

Phone

(253) 441-4743

Fax

(253) 620-5831

NPI assigned

Jan 4, 2012

Last updated

Jan 29, 2019By the provider in NPPES

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

Enrolled in WA

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health CareGroup PAC ID 1850201559, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir4.healow.com/fhir/r4/HEDCAA
• Direct secure messaging: virginia.buccolatournay.p1@direct.chc-tacoma.nextgenshare.com

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.

• Community Health Care

  • Federally Qualified Health Center (FQHC)
  • Tacoma, WA
  • NPI 1790762755
  Medicare reassignment Care Compare group NPD
• Community Health Care

  dba Puyallup

  • Federally Qualified Health Center (FQHC)
  • Puyallup, WA
  • NPI 1003515594
  NPD

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1124398482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 6TH AVE",
            "address_2": "APT 503",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98402",
            "telephone_number": "253-620-5015",
            "fax_number": "253-620-5831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 MLK JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98405",
            "telephone_number": "253-441-4743",
            "fax_number": "253-620-5831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCOLA",
        "first_name": "VIRGINIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00125750",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60296557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alysse Bryson, MSPAS, PA-C
• Jason Thomas Brzuchalski, DNP
• Sarah M Buban, LMHCA, MHP, CDPT
• Brent Thomas Bubany, MD
• Ashley Marie Bublitz, LMHCA
• Daniel Robert Buchanan
• Izabella Anna Buchanan, LICSW
• Jason R Buchanan, MD
• Justin Daniel Buchanan, DDS
• Kelsie Marie Buchanan, BS

• Psychiatric/Mental Health Nurse Practitioner in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.