Demetria Buckner, BS HEALTH SCIENCES,

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

Practice address

5901 Walsham Way
Indianapolis, IN 46254-2327

Phone

(317) 509-7674

NPI assigned

Mar 6, 2013

Last updated

Mar 19, 2024By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Outreach Mobile Lab, LLC

  • Phlebotomy Technician
  • Indianapolis, IN
  • NPI 1700643764

  Community Health Worker

  NPD (past) Authorized official

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1346581949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 A WEST 86TH ST #1289",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683605",
            "telephone_number": "317-567-1293",
            "fax_number": "317-981-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 WALSHAM WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462542327",
            "telephone_number": "317-509-7674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "DEMETRIA",
        "name_prefix": "Miss",
        "credential": "BS HEALTH SCIENCES,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-06",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Benjamin Buckley, DO
• Ricky L Buckley
• Rose Jackson Buckley, HSPP
• Brian Buckner, RPH.
• Debra Denise Buckner, M.S.W., L.C.S.W.
• Jason L Buckner, MD
• Mackenzie Marie Budd, DO
• Victoria R Budd, RD
• Erin Budi, PHARMD
• Matthew Budi, PHARM.D.

• Phlebotomy Technician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Phlebotomy Technician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.