Active NPI
Randy S. Buckles, DO, Family Health Care, LLC
- Family Medicine Physician
- Saint Joseph, MO
National Provider Identifier
1396753422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- RANDY S. BUCKLES, DO, FAMILY HEALTH CARE, LLC
- Practice address
- 220 South Woodbine Rd
Saint Joseph, MO 64506 - Phone
- (816) 676-1300
- Fax
- (816) 676-1400
- NPI assigned
- Aug 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Patricia Ann Buckles
- Title
- Office Manager
- Phone
- (816) 676-1300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
220 South Woodbine Rd
Saint Joseph, MO 64506
Mailing address
220 South Woodbine Rd
Saint Joseph, MO 64506
Phone (816) 676-1300
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 458858 | Other | MO | FREEDOM/HEALTHLINK ID |
| 10001359400 | Other | MO | CHP ID |
| 27020012 | Other | MO | BCKC GRP ID |
| 458828 | Other | MO | HEALTHLINK GRP ID |
| CH5327 | Other | MO | RAILROAD RETIREMENT BOARD |
| 10001359400 | Other | MO | COMMUNITY HEALTH PLAN |
| 2326850 | Other | MO | AETNA PROV ID |
| 499640064 | Other | MO | WPS/WEST REG. CLAIMS ID |
| 505804906 | Medicaid | MO |
Other names 1
- Family Health Care, LLC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D0948040 | Buckles Family Health Care, LLC | Certificate of waiver | Jun 29, 2028 |
National Provider Directory
National Provider DirectoryLocations
220 S Woodbine Rd
Saint Joseph, MO 64506
Phone (816) 676-1300
3935 Sherman Ave
Saint Joseph, MO 64506
Phone (816) 233-7300
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Saint Joseph, MO
- NPI 1447268560
-
- Nurse Practitioner
- Saint Joseph, MO
- NPI 1437165743
-
- Family Medicine Physician
- Saint Joseph, MO
- NPI 1669805818
-
- Internal Medicine Physician
- Grand Haven, MI
- NPI 1225299928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1262044800000",
"number": "1396753422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 SOUTH WOODBINE RD",
"city": "SAINT JOSEPH",
"state": "MO",
"postal_code": "64506",
"telephone_number": "816-676-1300",
"fax_number": "816-676-1400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 SOUTH WOODBINE RD",
"city": "SAINT JOSEPH",
"state": "MO",
"postal_code": "64506",
"telephone_number": "816-676-1300",
"fax_number": "816-676-1400"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RANDY S. BUCKLES, DO, FAMILY HEALTH CARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-04",
"last_updated": "2009-12-29",
"status": "A",
"authorized_official_last_name": "BUCKLES",
"authorized_official_first_name": "PATRICIA",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "816-676-1300"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FREEDOM/HEALTHLINK ID",
"identifier": "458858",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHP ID",
"identifier": "10001359400",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCKC GRP ID",
"identifier": "27020012",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK GRP ID",
"identifier": "458828",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD RETIREMENT BOARD",
"identifier": "CH5327",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY HEALTH PLAN",
"identifier": "10001359400",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROV ID",
"identifier": "2326850",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WPS/WEST REG. CLAIMS ID",
"identifier": "499640064",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "505804906",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Family Health Care, LLC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Saint Joseph, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.