Mary Hannah Bucklew, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

904350 Issued in MS

Practice address

1325 E Fortification St
Jackson, MS 39202-2442

Phone

(601) 354-4488

Fax

(601) 351-5980

NPI assigned

Jul 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mississippi Sports Medicine and Orthopaedic CenterGroup PAC ID 4981685310, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
• King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057
• Mississippi Methodist Rehab Ctr Hospital, Jackson, MS, CCN 250152

Merit-based Incentive Payment System (MIPS)

Final score

81.39 of 100Reported as group

Quality

65.98

Improvement activities

40

Cost

74.48

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbucklew3070454@direct.casso.us.com

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.

• Mississippi Sports Medicine & Orthopaedic Center

  • Orthopaedic Surgery Physician
  • Jackson, MS
  • NPI 1568415560

  MS

  Medicare reassignment Care Compare group NPD
• Choctaw Regional Medical Center

  • Critical Access Hospital
  • Ackerman, MS
  • NPI 1568879864

  MS

  Medicare reassignment NPD
• Ridgeland Medical Clinic

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1053917849

  MS

  Medicare reassignment NPD
• Choctaw Regional Medical Center

  • Family Medicine Physician
  • Ackerman, MS
  • NPI 1235547878

  MS

  Medicare reassignment
• R3 Wellness and Infusion, LLC

  • Family Nurse Practitioner
  • Gluckstadt, MS
  • NPI 1730067695
  NPD (past)
• Sports Medicine Pharmacy LLC

  • Pharmacy
  • Flowood, MS
  • NPI 1912452921
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• King'S Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464

  Hospital

  Care Compare affiliation
• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585

  Hospital

  Care Compare affiliation
• Mississippi Methodist Hospital & Rehabilitation Center, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Tupelo, MS
  • NPI 1205604071

  Hospital

  Care Compare affiliation
• Mississippi Methodist Hospital & Rehabilitation Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1841349792

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1467024901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14724 HIGHWAY 15 N",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "393396318",
            "telephone_number": "662-773-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-354-4488",
            "fax_number": "601-351-5980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14724 Highway 15 N",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "MS",
            "postal_code": "393396318",
            "country_code": "US",
            "telephone_number": "662-773-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKLEW",
        "first_name": "MARY",
        "middle_name": "HANNAH",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Buck, M.D.
• Rolanda Buck
• Earl Buckhanan
• Monique Buckhaulter, LPC
• Kelly Buckholdt, PH.D.
• Christen H Buckley, NP-C
• Evan Anthony Buckley, DO
• Buckner Prosthetic and Orthotic Laboratories Inc.
• Anna Michelle Buckner, LPC
• Deyanna Buckner

• All providers in Jackson, MS
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.
• 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.

Verify at the official NPI Registry.