Active NPI
Latrice Buck
- Social Worker
- Milwaukee, WI
National Provider Identifier
1396983110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 4400 W Melvina St
Milwaukee, WI 53216-2435 - Phone
- (414) 334-1455
- NPI assigned
- Feb 2, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 12098 | WI | |
| Social Worker | 104100000X | WI | Primary |
Addresses
Primary practice location
4400 W Melvina St
Milwaukee, WI 53216-2435
Mailing address
4400 W. Melvina Ave
Milwaukee, WI 53216
Phone (414) 334-1455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39748500 | Medicaid | WI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12098 | WI | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233532800000",
"number": "1396983110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 W. MELVINA AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "53216",
"telephone_number": "414-334-1455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 W MELVINA ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532162435",
"telephone_number": "414-334-1455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCK",
"first_name": "LATRICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-02",
"last_updated": "2009-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "12098",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39748500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.