Johnny Jason Buck, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-13746 Issued in AZ

Practice address

14256 S 47TH St
Phoenix, AZ 85044-6205

Phone

(480) 510-8502

NPI assigned

Jul 13, 2012

Last updated

Jul 13, 2012By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brightside Medical PAGroup PAC ID 3678948809, 92 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Brightside Medical, P.a.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1609335660

  AZ

  Medicare reassignment Care Compare group NPD
• Seachange Overall Wellness, PLLC

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1700132131
  NPD (past) Authorized official
• Brain Solutions PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mesa, AZ
  • NPI 1548692742

  Professional

  NPD (past)

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342137600000",
    "number": "1144575382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14256 S 47TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446205",
            "telephone_number": "480-510-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14256 S 47TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446205",
            "telephone_number": "480-510-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "JOHNNY",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-13",
        "last_updated": "2012-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-13746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey R Buchhalter, M.D.
• Kimberly Bucich, R.D.
• Buck Healthcare LLC
• Jena Paige Buck, OTD, OTR
• Jennifer Marie Buck, M.A., CCC-SLP
• Rachel Groetsch Buck, DO
• Ryan James Buck
• Sean Donovan Buck, MD
• Buckhorn Residential
• Buckhorn Treatment Center at South Mountain

• Professional Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.
• 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.