Individual provider Active NPI

Mark Richard Buckles, D.C.

  • Chiropractor
  • Florence, KY
National Provider Identifier
1295805497
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4937 Issued in KY
Practice address
7211 US 42
Florence, KY 41042-1901
Phone
(859) 817-0817
Fax
(859) 817-1329
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4937 KY Primary

Addresses

Primary practice location

7211 US 42
Florence, KY 41042-1901

Mailing address

7211 US 42
Florence, KY 41042-1901
Phone (859) 817-0817

Other identifiers 1

IdentifierTypeStateIssuer
2389204MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110613000091 KY Practitioner - Chiropractic 7214839141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7211 US Hwy 42
Florence, KY 41042-1901
Phone (859) 817-0817

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4937KYMDChiropractor
2574OHMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M.M.S.C.;Inc Chiropractor CurrentSince Nov 11, 2003 Accepting new patients

Locations

7211 US Highway 42
Florence, KY 41042
Phone (606) 371-1153

5108 Crookshank Rd
Cincinnati, OH 45238
Phone (513) 451-1726

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1295805497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 US 42",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410421901",
            "telephone_number": "859-817-0817",
            "fax_number": "859-817-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 US 42",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410421901",
            "telephone_number": "859-817-0817",
            "fax_number": "859-817-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLES",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2389204",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.