Individual provider Active NPI

Jennifer Margaret Buckler, MS.,CCC-SLP

  • Speech-Language Pathologist
  • Glendale, AZ
National Provider Identifier
1497883417
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP1547 Issued in AZ
Practice address
6330 W Thunderbird Rd
Glendale, AZ 85306-4002
Phone
(623) 486-6000
NPI assigned
Mar 1, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP1547 AZ Primary

Addresses

Primary practice location

6330 W Thunderbird Rd
Glendale, AZ 85306-4002

Mailing address

9031 W Tony CT
Peoria, AZ 85382-8109
Phone (623) 815-7961

Other identifiers 1

IdentifierTypeStateIssuer
104539MedicaidAZ

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLP1547AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Peoria Unified School District Past Accepting new patients
Peoria Unified School District #11 Past Accepting new patients
Midwestern University Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1497883417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9031 W TONY CT",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828109",
            "telephone_number": "623-815-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064002",
            "telephone_number": "623-486-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLER",
        "first_name": "JENNIFER",
        "middle_name": "MARGARET",
        "name_prefix": "Mrs.",
        "credential": "MS.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP1547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104539",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.