Individual provider Active NPI

Kerri Lee Buckley, RN, MSN, FNP-BC

  • Family Nurse Practitioner
  • Norwell, MA
National Provider Identifier
1447500947
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN261386 Issued in MA
Practice address
143 Longwater Dr
Norwell, MA 02061-1683
Phone
(781) 878-5200
NPI assigned
Sep 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN261386 MA Primary

Addresses

Primary practice location

143 Longwater Dr
Norwell, MA 02061-1683

Mailing address

143 Longwater Dr
Norwell, MA 02061-1683
Phone (781) 878-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20121204000276 MA Practitioner - Nurse Practitioner 7416109145 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN261386MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Medical Center, Inc. CurrentSince Jun 1, 2016 Accepting new patients
Coastal Medical Associates CurrentSince Apr 10, 2020 Accepting new patients

Locations

5 Tarkiln Rd
Kingston, MA 02364
Phone (781) 585-2200

143 Longwater Dr
Norwell, MA 02061
Phone (781) 792-4136

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

55 Fogg Rd
#81
Weymouth, MA 02190

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": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1447500947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 LONGWATER DR",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611683",
            "telephone_number": "781-878-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 LONGWATER DR",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611683",
            "telephone_number": "781-878-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "KERRI",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN261386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwell, MA

Sources for this page

Verify at the official NPI Registry.