Individual provider Active NPI

James W Buechele, PHD

  • Psychologist
  • Hernando, MS
National Provider Identifier
1184763229
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
30447 Issued in MS
Practice address
2164 Paris CV
Hernando, MS 38632-1609
Phone
(901) 219-3075
Fax
(901) 527-1326
NPI assigned
Feb 5, 2007
Last updated
Jun 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 30447 MS Primary
Psychologist 103T00000X 1381 TN
Cognitive & Behavioral Psychologist 103TB0200X 30447 MS
Cognitive & Behavioral Psychologist 103TB0200X 1381 TN

Addresses

Primary practice location

2164 Paris CV
Hernando, MS 38632-1609

Mailing address

2164 Paris CV
Hernando, MS 38632-1609
Phone (901) 219-3075

Other identifiers 1

IdentifierTypeStateIssuer
00119063MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20080430000583 MS Practitioner - Clinical Psychologist 0547349649 Practice locations: Olive Branch, MS

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
30447MSMDCognitive & Behavioral Psychologist
1381TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Services of the Mid-South Past Accepting new patients
Optimum Behavioral Health, Inc. Past Accepting new patients
Midsouth Behavioral Health, PLLC Past Accepting new patients

Organizations & group practices 3

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1184763229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2164 PARIS CV",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386321609",
            "telephone_number": "901-219-3075",
            "fax_number": "901-527-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2164 PARIS CV",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386321609",
            "telephone_number": "901-219-3075",
            "fax_number": "901-527-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUECHELE",
        "first_name": "JAMES",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MS",
            "license": "30447",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "1381",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MS",
            "license": "30447",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "TN",
            "license": "1381",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119063",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hernando, MS

Sources for this page

Verify at the official NPI Registry.