NPIMap

Individual provider Active NPI

James Kyle Buck III, MD

  • Anesthesiology Physician
  • Kingsport, TN
National Provider Identifier
1477057214
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2020-02785 Issued in NC
Practice address
10415 Wallace Alley St
Kingsport, TN 37663-3936
Phone
(423) 390-0451
NPI assigned
Mar 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2020-02785 NC Primary

Addresses

Primary practice location

10415 Wallace Alley St
Kingsport, TN 37663-3936

Mailing address

10415 Wallace Alley St
Kingsport, TN 37663-3936
Phone (423) 390-0451

Other practice location 1

1 Medical Center Boulevard
Winston Salem, NC 27157-0001
Phone (336) 716-4426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220621000552 NC Practitioner - Anesthesiology 1153670948 Reassigns benefits to 2 organizations
I20230727000939 TN Practitioner - Anesthesiology 1153670948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
East Tennessee State University Quillen College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology Consultants of North Carolina PLLCGroup PAC ID 7810256971, 24 clinicians
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000

2400 W Friendly Ave
Greensboro, NC 27403-1109
Phone (336) 832-1000

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091
  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2022 Accepting new patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Jul 1, 2023 Accepting new patients
Anesthesiology Consultants of North Carolina PLLC Anesthesiology CurrentSince Aug 30, 2024 Accepting new patients
Paragon Anesthesia PC Anesthesiology CurrentSince Jul 1, 2023 Accepting new patients
Singing River Health System PastSince Sep 10, 2023 Accepting new patients

Locations

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451

Interoperability endpoints

  • Direct secure messaging: jbuck2915836@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1477057214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10415 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-390-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10415 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-390-0451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Boulevard",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271570001",
            "country_code": "US",
            "telephone_number": "336-716-4426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCK",
        "first_name": "JAMES",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2020-02785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.