Active NPI
Miracle Buckley, OTR
- Occupational Therapist
- Brooklyn, NY
National Provider Identifier
1366927352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 380 Henry St
Brooklyn, NY 11201-6048 - Phone
- (718) 855-6789
- NPI assigned
- Sep 26, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
380 Henry St
Brooklyn, NY 11201-6048
Mailing address
340 Arbor Dr Apt 1362
Ridgeland, MS 39157-4856
Phone (601) 454-3322
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702252800000",
"number": "1366927352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 ARBOR DR APT 1362",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391574856",
"telephone_number": "601-454-3322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 HENRY ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112016048",
"telephone_number": "718-855-6789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKLEY",
"first_name": "MIRACLE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-26",
"last_updated": "2023-12-11",
"certification_date": "2023-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.