Kyle Kelley Buck, OTR

Primary specialty

Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X

License

106101 Issued in MN

Practice address

800 E 28TH St
Minneapolis, MN 55407-3723

Phone

(612) 863-4000

NPI assigned

Feb 3, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Novacare Outpatient Rehabilitation East Inc

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Vadnais Heights, MN
  • NPI 1518963909

  Neurorehabilitation

  NPD
• Novacare Outpatient Rehabilitation East Inc

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Fridley, MN
  • NPI 1558610519
  NPD
• Novacare Outpatient Rehabilitation East Inc

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Ferndale, MI
  • NPI 1245235191
  NPD

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1235760752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 PLEASANT AVE APT 203",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081451",
            "telephone_number": "507-319-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "KYLE",
        "middle_name": "KELLEY",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "MN",
            "license": "106101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Bucholz, LADC
• Mary Buchta, LICSW
• Anne Buchwald, LMFT
• Henry Buchwald, M.D., PHD
• Erin Elizabeth Buck, DPT
• Lisa Nave Buck, R.D.
• Brien Buckentine
• Melissa Buckentine
• Danielle Melissa Bucki
• Joshua Michael Buckler, M.D.

• Neurorehabilitation Occupational Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Neurorehabilitation Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.