Active NPI
Jaclyn Marie Buck, APRN-CNP
- Nurse Practitioner
- Cincinnati, OH
National Provider Identifier
1215427703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN.CNP.023225
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.023225 | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital Medical Center | Nurse Practitioner | Current | 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.
-
- Pediatrics Physician
- Cincinnati, OH
- NPI 1609915784
Nurse Practitioner
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.