Kimberly M Buckley, ARNP

Key facts

NPI

1265615504

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

2005009417 (MO)

Practice address

21107 Donahoo Rd
Tonganoxie, KS 66086-4153

Phone

(913) 742-4084

Fax

(913) 742-4086

NPI assigned

Dec 10, 2007

Sex

Female

Sole proprietor

No

Organizations & group practices 8

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.

• Banner - University Physician Specialists LLC Multi-Specialty Clinic/Center · Phoenix, AZ · NPI 1437529245
  Medicare reassignment Care Compare group NPD AZ
• Mid America Senior Management LLC Internal Medicine Physician · Tonganoxie, KS · NPI 1942356977
  Medicare reassignment NPD KS
• Tri-City Cardiology Consultants, PC Cardiovascular Disease Physician · Mesa, AZ · NPI 1144288416
  Medicare reassignment NPD AZ
• Banner - University Physician Specialists LLC Multi-Specialty Clinic/Center · Maricopa, AZ · NPI 1063887727
  NPD
• Banner - University Physician Specialists LLC Durable Medical Equipment & Medical Supplies · Phoenix, AZ · NPI 1164255865
  NPD
• Tri-City Cardiology Consultants, PC Cardiac Rehabilitation Registered Nurse · Mesa, AZ · NPI 1689417636
  NPD
• College Park Family Care Center PA Family Medicine Physician · Overland Park, KS · NPI 1740248772
  NPD (past)
• Mid America Senior Management Aco LLC Internal Medicine Physician · Tonganoxie, KS · NPI 1326888900
  NPD (past)

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner - University Medical Center Phoenix General Acute Care Hospital · Phoenix, AZ · NPI 1841224870
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner - University Physician Specialists LLC (343 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner - University Medical Center Phoenix Hospital · Phoenix, AZ · CCN 030002

Merit-based Incentive Payment System (MIPS)

Final score

85.24 of 100 (group)

Quality

74.76

Promoting interoperability

100

Improvement activities

40

Cost

76.03

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in KS, AZ

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 7, 2011.

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1265615504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21107 DONAHOO RD",
            "city": "TONGANOXIE",
            "state": "KS",
            "postal_code": "660864153",
            "telephone_number": "913-742-4084",
            "fax_number": "913-742-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21107 DONAHOO RD",
            "city": "TONGANOXIE",
            "state": "KS",
            "postal_code": "660864153",
            "telephone_number": "913-742-4084",
            "fax_number": "913-742-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-10",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2005009417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2005009417",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP - KS",
            "identifier": "53-46082-081",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Tonganoxie, KS · Family Nurse Practitioner in Kansas