Individual provider Active NPI

Craig E Buckles, MD

  • Psychiatry Physician
  • Anderson, IN
National Provider Identifier
1487689527
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01038611 Issued in IN
Practice address
2210 Jackson St
Anderson, IN 46016-4363
Phone
(765) 683-3118
NPI assigned
Jul 11, 2006
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01038611 IN Primary

Addresses

Primary practice location

2210 Jackson St
Anderson, IN 46016-4363

Mailing address

2210 Jackson St
Anderson, IN 46016-4363

Other identifiers 2

IdentifierTypeStateIssuer
000000245158OtherANTHEM PIN NUMBER
100107730MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address craig.buckles.1@7598.direct.athenahealth.com ST. VINCENT ANDERSON REGIONAL HOSPITAL, INC.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050829000794 IN Practitioner - Psychiatry 4082645098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Indiana University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1916 Jackson St
Anderson, IN 46016-4336
Phone (765) 683-3149

1931 Brown St
Anderson, IN 46016-4206
Phone (765) 646-8247

2015 Jackson St
Anderson, IN 46016-4337
Phone (765) 646-8179

2020 Meridian St
Anderson, IN 46016-4343

2020 Meridian St
Suite 100
Anderson, IN 46016-4338
Phone (765) 646-8509

2210 Jackson St
Anderson, IN 46016-4363
Phone (765) 644-1414

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01038611INMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Anderson Regional Hospital, Inc. CurrentSince Jan 1, 2013 Accepting new patients
St. Vincent Anderson Regional Hospital, Inc. Psychiatry CurrentSince Jan 1, 2013 Accepting new patients
Amh, Inc Past Accepting new patients
Central Indiana OB/GYN, LLC Past Accepting new patients

Locations

2210 Jackson St
Anderson, IN 46016
Phone (765) 644-1414

Interoperability endpoints

  • Direct secure messaging: craig.buckles.1@7598.direct.athenahealth.com

Organizations & group practices 4

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

Hospital & facility affiliations 4

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1487689527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 JACKSON ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 JACKSON ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164363",
            "telephone_number": "765-683-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLES",
        "first_name": "CRAIG",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01038611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN NUMBER",
            "identifier": "000000245158",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100107730",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "craig.buckles.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "ST. VINCENT ANDERSON REGIONAL HOSPITAL, INC.",
            "address_1": "2210 Jackson St",
            "city": "Anderson",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460164363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.