Individual provider Active NPI

Calvin L Buckner II

  • Personal Care Attendant
  • Gordon, WV
National Provider Identifier
1386255289
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
12340 Chap Rd
Gordon, WV 25093-9427
Phone
(304) 245-8163
NPI assigned
Aug 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Primary

Addresses

Primary practice location

12340 Chap Rd
Gordon, WV 25093-9427

Mailing address

PO Box 313
Van, WV 25206-0313
Phone (304) 245-8163

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1386255289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 313",
            "city": "VAN",
            "state": "WV",
            "postal_code": "252060313",
            "telephone_number": "304-245-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12340 CHAP RD",
            "city": "GORDON",
            "state": "WV",
            "postal_code": "250939427",
            "telephone_number": "304-245-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "CALVIN",
        "middle_name": "L",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gordon, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.