Individual provider Active NPI

Justin Reeves Buland, DO

  • Neonatal-Perinatal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1235391822
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
2017010897 Issued in MO
Practice address
1 Childrens PL
Saint Louis, MO 63110
Phone
(314) 454-6148
Fax
(314) 454-4633
NPI assigned
Jun 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2017010897 MO
Pediatrics Physician 208000000X OS015778 PA
Neonatal-Perinatal Medicine Physician 2080N0001X OS015778 PA
Neonatal-Perinatal Medicine Physician 2080N0001X 2017010897 MO Primary

Addresses

Primary practice location

1 Childrens PL
Saint Louis, MO 63110

Mailing address

1 Childrens PL
MSC 8515-87-1200
Saint Louis, MO 63110
Phone (314) 454-6148

Other identifiers 1

IdentifierTypeStateIssuer
ENROLLEDMedicaidIL

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
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS015778PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Akron Children'S Hospital Current Accepting new patients
Children'S Hospital Medical Center of Akron Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jbuland112283@direct.chmca.org

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1235391822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "MSC 8515-87-1200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-454-6148",
            "fax_number": "314-454-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-454-6148",
            "fax_number": "314-454-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULAND",
        "first_name": "JUSTIN",
        "middle_name": "REEVES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2017010897",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS015778",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "PA",
            "license": "OS015778",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MO",
            "license": "2017010897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.