John Buckner, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

R-2647 Issued in AR

Practice address

143 Ridgeland Dr
Maumelle, AR 72113-6000

Phone

(501) 851-2137

NPI assigned

Nov 26, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1144564410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 RIDGELAND DR",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721136000",
            "telephone_number": "501-851-2137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 RIDGELAND DR",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721136000",
            "telephone_number": "501-851-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "R-2647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "B90019",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110328001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslyn Dyan Boyland
• Brent Bradley, P.D.
• Kathryn Leeann Brown, O.D.
• Nicholas Brucker, MD
• Lindsey Irene Bryant, APRN
• Charla Burkett, S.L.P.
• Jeffrey John Carfagno, MD
• Katie Janette Carillon, P.A.C.
• Katrina Carpenter, APRN, PMHNP-BC
• Hannah Castleberry, PHARMD

• Diagnostic Radiology Physician in Maumelle, AR
• Providers in Maumelle, AR by specialty
• Diagnostic Radiology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.