NPIMap

Organization Active NPI

Buckelew Programs

  • Case Management Agency
  • Santa Rosa, CA
National Provider Identifier
1518012020
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
BUCKELEW PROGRAMS
Practice address
2235 Mercury Way Ste 107
Santa Rosa, CA 95407-5472
Phone
(707) 571-5581
Fax
(707) 571-5531
NPI assigned
Jan 24, 2007
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Mr. Chris Kughn, MSW
Title
Chief Executive Officer
Phone
(415) 720-4197

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU Primary

Addresses

Primary practice location

2235 Mercury Way Ste 107
Santa Rosa, CA 95407-5472

Mailing address

2235 Mercury Way Ste 107
Santa Rosa, CA 95407-5472
Phone (707) 571-5581

Other names 1

  • Buckelew Programs Sonoma County Other name

National Provider Directory

National Provider Directory
Tax ID family
Buckelew Programs13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2300 Northpoint Pkwy
Santa Rosa, CA 95407
Phone (707) 571-5581

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1518012020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 MERCURY WAY STE 107",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075472",
            "telephone_number": "707-571-5581",
            "fax_number": "707-571-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 MERCURY WAY STE 107",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075472",
            "telephone_number": "707-571-5581",
            "fax_number": "707-571-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKELEW PROGRAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "KUGHN",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "415-720-4197",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buckelew Programs Sonoma County",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Buckelew Programs Sonoma County",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.