Individual provider Active NPI

Jaclyn Marie Buck, APRN-CNP

  • Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1215427703
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.023225 Issued in OH
Practice address
3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone
(513) 636-4466
NPI assigned
May 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nurse Practitioner 363L00000X APRN.CNP.023225 OH Primary

Addresses

Primary practice location

3333 Burnet Ave
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Avenue
MLC 1013
Cincinnati, OH 45229-3026
Phone (513) 636-4466

Other names 1

  • Ms. Jaclyn Marie Sagen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.023225OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center Nurse Practitioner CurrentSince Aug 9, 2018 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

3333 Burnet Ave
#1013
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

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.

NPI Registry JSON

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1215427703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "MLC 1013",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4466",
            "fax_number": "513-636-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-10",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.023225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "SAGEN",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.