Mary Anna Buckner, RBT-18-73005

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-18-73005 Issued in FL

Practice address

1288 Hazelnut St
Bunnell, FL 32110-6732

Phone

(386) 864-9391

Fax

(386) 226-2076

NPI assigned

Feb 22, 2019

Last updated

Feb 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1356808661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1288 HAZELNUT ST",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321106732",
            "telephone_number": "386-864-9391",
            "fax_number": "386-226-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1288 HAZELNUT ST",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321106732",
            "telephone_number": "386-864-9391",
            "fax_number": "386-226-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "MARY",
        "middle_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "RBT-18-73005",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-18-73005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen R. Bickel, M.D.
• Kristina H Blanchek, MDIV
• Andrew Bliss
• Ronda Maria Bostick, LMHC
• Martha Bradley, LMHC
• Bunnell Medical Center Inc
• Bunnell Pharmacy Inc
• Carlisi Chiropractic Center Inc.
• Roy Carlisi, D.C.
• Chance 2 Change (Break The Cycle)

• Behavior Technician in Bunnell, FL
• Providers in Bunnell, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.