Active NPI
John Buckner, O.D.
- Ophthalmic Technician/Technologist
- Gainesville, FL
National Provider Identifier
1194850388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmic Technician/Technologist
- License
- 792
- Practice address
- 6757 W Newberry Rd
Gainesville, FL 32605 - Phone
- (352) 331-2040
- Fax
- (352) 331-1526
- NPI assigned
- Feb 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmic Technician/Technologist | 156FX1100X | 792 | FL | Primary |
Addresses
Primary practice location
6757 W Newberry Rd
Gainesville, FL 32605
Mailing address
6757 W Newberry Rd
Gainesville, FL 32605
Phone (352) 331-2040
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 084305900 | Medicaid | FL | |
| 421588508 | Other | FL | TAX ID |
| 796 | Other | FL | FLORDIA LIC NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 792 | FL | MD | Ophthalmic Technician/Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Super Optical Express | Past | Accepting new patients | |
| Jose R Arnao O.D. P.a. | 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 and National Provider Directory roles.
-
- Optometrist
- Gainesville, FL
- NPI 1457630451
-
- Optometrist
- Gainesville, FL
- NPI 1639325434
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297382400000",
"number": "1194850388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6757 W NEWBERRY RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "32605",
"telephone_number": "352-331-2040",
"fax_number": "352-331-1526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6757 W NEWBERRY RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "32605",
"telephone_number": "352-331-2040",
"fax_number": "352-331-1526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKNER",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2011-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1100X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Ophthalmic",
"state": "FL",
"license": "792",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "084305900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "421588508",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORDIA LIC NUMBER",
"identifier": "796",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.