Individual provider Active NPI

Christina N Buckley, FNP-BC, ENP-C

  • Family Nurse Practitioner
  • Fort Campbell, KY
National Provider Identifier
1538447016
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15944 Issued in TN
Practice address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone
(270) 798-8500
NPI assigned
Aug 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R 211982-1 CNP MN
Family Nurse Practitioner 363LF0000X 3009175 KY
Family Nurse Practitioner 363LF0000X 15944 TN Primary

Addresses

Primary practice location

650 Joel Dr
Fort Campbell, KY 42223-5318

Mailing address

785 Fire Break Dr
Clarksville, TN 37040-5582

Other identifiers 2

IdentifierTypeStateIssuer
R 211982-1 CNPOtherMNSTATE LICENCE
7100353170MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111010000504 TN Practitioner - Nurse Practitioner 5799957080 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3009175KYMDFamily Nurse Practitioner
R 211982-1 CNPMNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee Ed, PLLC CurrentSince Apr 29, 2021 Accepting new patients

Locations

5121 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 436-6556

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1538447016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 FIRE BREAK DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "CHRISTINA",
        "middle_name": "N",
        "credential": "FNP-BC, ENP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R 211982-1 CNP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009175",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "15944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "R 211982-1 CNP",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100353170",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

Verify at the official NPI Registry.