Individual provider Active NPI

Tikeama Buckingham, FNP-BC

  • Family Nurse Practitioner
  • Newport News, VA
National Provider Identifier
1255725016
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024178685 Issued in VA
Practice address
11745 Jefferson Ave Ste 10B
Newport News, VA 23606-4418
Phone
(513) 834-7063
NPI assigned
Mar 19, 2015
Last updated
Dec 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024178685 VA Primary
Registered Nurse 163W00000X 586622-1 NY

Addresses

Primary practice location

11745 Jefferson Ave Ste 10B
Newport News, VA 23606-4418

Mailing address

615 Elsinore PL Ste 200
Cincinnati, OH 45202-1457
Phone (513) 834-7063

Other practice location 1

121 Spring Trace Ln
Newport News, VA 23601-1104
Phone (716) 548-8644

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL tbuckingham@rightpathcenters.com

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
586622-1NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Imperfections Health and Wellness LLC Current Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1255725016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ELSINORE PL STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021457",
            "telephone_number": "513-834-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11745 JEFFERSON AVE STE 10B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064418",
            "telephone_number": "513-834-7063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Spring Trace Ln",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236011104",
            "country_code": "US",
            "telephone_number": "716-548-8644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKINGHAM",
        "first_name": "TIKEAMA",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-19",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024178685",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "586622-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tbuckingham@rightpathcenters.com",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "121 Spring Trace Ln",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236011104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.