Individual provider Active NPI

Dannie Earl Buck, M.D.

  • Internal Medicine Physician
  • Ormond Beach, FL
National Provider Identifier
1366525750
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME62671 Issued in FL
Practice address
800 S Nova Rd
Suite a
Ormond Beach, FL 32174-7362
Phone
(386) 676-0505
Fax
(386) 676-0788
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME62671 FL Primary

Addresses

Primary practice location

800 S Nova Rd
Suite a
Ormond Beach, FL 32174-7362

Mailing address

PO Box 730607
Ormond Beach, FL 32173-0607
Phone (386) 676-0505

Other identifiers 1

IdentifierTypeStateIssuer
371526400MedicaidFL

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

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1366525750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730607",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321730607",
            "telephone_number": "386-676-0505",
            "fax_number": "386-676-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S NOVA RD",
            "address_2": "SUITE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321747362",
            "telephone_number": "386-676-0505",
            "fax_number": "386-676-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "DANNIE",
        "middle_name": "EARL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME62671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371526400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; 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.