Active NPI
Amy Tilson Buckley, LCSW
- Clinical Social Worker
- Little Rock, AR
National Provider Identifier
1427224435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2189-M
- Practice address
- 11 Children's Way Slot # 654
South Campus BLDG 5TH Floor
Little Rock, AR 72202-4610 - Phone
- (501) 364-1993
- NPI assigned
- Apr 30, 2008
- Last updated
- Feb 8, 2011
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2189-M | AR | Primary |
Addresses
Primary practice location
11 Children's Way Slot # 654
South Campus BLDG 5TH Floor
Little Rock, AR 72202-4610
Mailing address
218 Beechwood St
Little Rock, AR 72205-3814
Phone (501) 993-5511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 172504795 | Medicaid | AR |
Other names 1
- Ms. Amy Louisa Tilson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2189-M | AR | MD | Clinical Social Worker |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Little Rock, AR
- NPI 1225580913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297123200000",
"number": "1427224435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "218 BEECHWOOD ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722053814",
"telephone_number": "501-993-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 CHILDREN'S WAY SLOT # 654",
"address_2": "SOUTH CAMPUS BLDG 5TH FLOOR",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722024610",
"telephone_number": "501-364-1993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKLEY",
"first_name": "AMY",
"middle_name": "TILSON",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-30",
"last_updated": "2011-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "2189-M",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "172504795",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "TILSON",
"middle_name": "LOUISA",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.