Individual provider Active NPI

Mary Catherine Buckley, APRN

  • Acute Care Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1154004711
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
231227 Issued in LA
Practice address
2600 Greenwood Rd
Shreveport, LA 71103-3908
Phone
(318) 212-4000
NPI assigned
Aug 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 231227 LA Primary

Addresses

Primary practice location

2600 Greenwood Rd
Shreveport, LA 71103-3908

Mailing address

28419 Highway 9
Bienville, LA 71008-2856
Phone (318) 617-9592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20231122003443 LA Practitioner - Nurse Practitioner 6204284680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK North Pulmonary and Critical CareGroup PAC ID 1759382856, 22 clinicians

Practice addresses (Care Compare)

2551 Greenwood Rd
Suite 210
Shreveport, LA 71103-3985
Phone (318) 635-0834

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WK North Pulmonary & Critical Care CurrentSince Oct 9, 2023 Accepting new patients

Locations

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

2551 Greenwood Rd
Ste 210
Shreveport, LA 71103
Phone (318) 212-8159

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1154004711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28419 HIGHWAY 9",
            "city": "BIENVILLE",
            "state": "LA",
            "postal_code": "710082856",
            "telephone_number": "318-617-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GREENWOOD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033908",
            "telephone_number": "318-212-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "231227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.