Individual provider Active NPI

Amy T Buckner, MCD CCC A

  • Audiologist
  • Rogers, AR
National Provider Identifier
1184881880
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A#83 Issued in AR
Practice address
5204 W Redbud St
Rogers, AR 72758-8936
Phone
(479) 636-0110
Fax
(479) 631-0491
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A#83 AR Primary

Addresses

Primary practice location

5204 W Redbud St
Rogers, AR 72758-8936

Mailing address

5204 W Redbud St
Rogers, AR 72758-8936
Phone (479) 636-0110

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
80548TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Noble Anesthesia Partners, PLLC Past Accepting new patients
Texas Ear, Nose & Throat Specialists, PLLC Audiologist PastSince Jan 26, 1990 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1184881880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5204 W REDBUD ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588936",
            "telephone_number": "479-636-0110",
            "fax_number": "479-631-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5204 W REDBUD ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588936",
            "telephone_number": "479-636-0110",
            "fax_number": "479-631-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "AMY",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "MCD CCC A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AR",
            "license": "A#83",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.