Individual provider Active NPI

Stephen M Buck, R.PH.

  • Pharmacist
  • Traverse City, MI
National Provider Identifier
1154611366
Registry record updated Apr 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302021525 Issued in MI
Practice address
13916 S West Bay Shore Dr
Traverse City, MI 49684-6264
Phone
(231) 946-7400
NPI assigned
Apr 10, 2011
Last updated
Apr 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302021525 MI Primary

Addresses

Primary practice location

13916 S West Bay Shore Dr
Traverse City, MI 49684-6264

Mailing address

13916 S West Bay Shore Dr
Traverse City, MI 49684-6264
Phone (231) 946-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302021525MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Michigan Inc Past Accepting new patients
Rite Aid of Michigan Inc Past Accepting new patients

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": "1302393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302393600000",
    "number": "1154611366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13916 S WEST BAY SHORE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846264",
            "telephone_number": "231-946-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13916 S WEST BAY SHORE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846264",
            "telephone_number": "231-946-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-10",
        "last_updated": "2011-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302021525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.