Active NPI
Richard C Buck, M.D.
- Family Medicine Physician
- South Bend, IN
National Provider Identifier
1487615175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 21120
- Practice address
- 51916 State Road 933
South Bend, IN 46637-1708 - Phone
- (574) 272-1350
- Fax
- (574) 272-1337
- NPI assigned
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 21120 | IN | Primary |
Addresses
Primary practice location
51916 State Road 933
South Bend, IN 46637-1708
Mailing address
51916 U.S. 31 North
South Bend, IN 46637
Phone (574) 272-1350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 792083299 | Other | IN | RRMR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21120 | IN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234915200000",
"number": "1487615175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51916 U.S. 31 NORTH",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "46637",
"telephone_number": "574-272-1350",
"fax_number": "574-272-1337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51916 STATE ROAD 933",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466371708",
"telephone_number": "574-272-1350",
"fax_number": "574-272-1337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCK",
"first_name": "RICHARD",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2009-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "21120",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RRMR",
"identifier": "792083299",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.