Individual provider Active NPI

Gregory Franklin Buck, PA-C

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1437377397
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
501 Issued in SC
Practice address
96 Jonathan Lucas St 210 CSB
Charleston, SC 29425
Phone
(843) 792-5622
Fax
(843) 792-1707
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 501 SC Primary

Addresses

Primary practice location

96 Jonathan Lucas St 210 CSB
Charleston, SC 29425

Mailing address

1051 Loyalist LN
Mount Pleasant, SC 29464-9235
Phone (843) 881-2039

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gbuck5972@direct.musc.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071030000121 SC Practitioner - Physician Assistant 6406943026 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
501SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Sep 1, 2007 Accepting new patients
University Medical Associates of the Medical University of South Carol Physician Assistant CurrentSince Sep 1, 2007 Accepting new patients

Locations

96 Jonathan Lucas St
#210
Charleston, SC 29425
Phone (843) 792-1767

2125 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 573-1503

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

1300 Hospital Dr
Ste 210
Mt Pleasant, SC 29464
Phone (803) 884-2477

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1437377397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 LOYALIST LN",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294649235",
            "telephone_number": "843-881-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 JONATHAN LUCAS ST 210 CSB",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-792-5622",
            "fax_number": "843-792-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "GREGORY",
        "middle_name": "FRANKLIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gbuck5972@direct.musc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "96 jonathan lucas st 210 csb",
            "city": "charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.