Sarah Arlene Buck-Herdrich, MS RN PMHCNS-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

PPNS00075 Issued in RI

Practice address

107 Clock Tower SQ
Portsmouth, RI 02871-1396

Phone

(401) 293-5930

Fax

(401) 293-0097

NPI assigned

Jul 18, 2006

Last updated

Dec 4, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Miss Sarah Arlene Buck Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2016 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Registered Nurse

State licenses

Practice roles

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.

• Compass Rose Psychiatry, LLC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Portsmouth, RI
  • NPI 1992056758
  NPD (past) Authorized official
• Angell Street Psychiatry LTD

  • Psychiatry Physician
  • Warwick, RI
  • NPI 1114011756
  NPD (past)
• Community Care Alliance

  • Community/Behavioral Health Agency
  • Woonsocket, RI
  • NPI 1013288083
  NPD (past)
• Community Care Alliance

  • Community/Behavioral Health Agency
  • Woonsocket, RI
  • NPI 1437191061
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1285652941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CLOCK TOWER SQ",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028711396",
            "telephone_number": "401-293-5930",
            "fax_number": "401-293-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CLOCK TOWER SQ",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028711396",
            "telephone_number": "401-293-5930",
            "fax_number": "401-293-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK-HERDRICH",
        "first_name": "SARAH",
        "middle_name": "ARLENE",
        "name_prefix": "Mrs.",
        "credential": "MS RN PMHCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "PPNS00075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SB42521",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0000031092",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "0000041302",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "BUCK",
            "middle_name": "ARLENE",
            "prefix": "MISS",
            "credential": "MS RN PCNS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Todd Matthew Carbone, PTA

• Psychiatric/Mental Health Nurse Practitioner in Portsmouth, RI
• Providers in Portsmouth, RI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.