Active NPI
Leroy Selby Buck Jr., M.D.
- Psychiatry Physician
- Russellville, KY
National Provider Identifier
1306893722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 13284
- Practice address
- 237 E. Sixth St.
Russellville, KY 42276-1917 - Phone
- (270) 726-3629
- Fax
- (270) 726-3626
- NPI assigned
- May 30, 2006
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 13284 | KY | |
| Psychiatry Physician | 2084P0800X | 13284 | KY | Primary |
Addresses
Primary practice location
237 E. Sixth St.
Russellville, KY 42276-1917
Mailing address
907 Eagle CT.
Bowling Green, KY 42103-2515
Phone (270) 843-1371
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13284 | Other | KY | STATE LICENSE |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13284 | KY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth of Kentucky | Psychiatry | Past | Accepting new patients |
| Lifeskills, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Western State Nursing Facility
- Psychiatry Physician
- Hopkinsville, KY
- NPI 1134124167
-
- Community/Behavioral Health Agency
- Bowling Green, KY
- NPI 1669401816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1306893722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "907 EAGLE CT.",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421032515",
"telephone_number": "270-843-1371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "237 E. SIXTH ST.",
"city": "RUSSELLVILLE",
"state": "KY",
"postal_code": "422761917",
"telephone_number": "270-726-3629",
"fax_number": "270-726-3626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCK",
"first_name": "LEROY",
"middle_name": "SELBY",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-30",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "KY",
"license": "13284",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "KY",
"license": "13284",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "13284",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Russellville, KY
- Bowling Green-Warren County Community Hospital Corporation (Med Center Health Primary Care Russellville)
- Bowling Green-Warren County Community Hospital Corporation (The Medical Center at Russellville)
- Jane Rebecca Brasseale, PT, DPT
- Wesley A Bratcher, DPT
- Brian Lynch
- Kimberly Cheree Buckner, PMHNP-BC
- Laura Bush, LPCC
- Lee Ann Byrd, BHS
- Trisha Kelly Campbell, APRN
- Ashlyn Carey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.