Jacqueline R. Buckley, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

JACQUELINE R. BUCKLEY, LLC

Practice address

1412 SW 43Rd St
Renton, WA 98057-4803

Phone

(360) 504-6665

Fax

(844) 979-3080

NPI assigned

May 26, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Jacqueline Renee Buckley, DPMNPI 1518246628

Title

Owner

Phone

(404) 808-4486

Specialties & licenses 1

Addresses

Other names 1

• Roka Foot and Ankle Centers Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Renee Buckley, DPM

  • Foot & Ankle Surgery Podiatrist
  • Kirkland, WA
  • NPI 1518246628
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590451200000",
    "number": "1568085454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9706 S 230TH PL",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980312728",
            "telephone_number": "404-808-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 SW 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574803",
            "telephone_number": "360-504-6665",
            "fax_number": "844-979-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE R. BUCKLEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A",
        "authorized_official_last_name": "BUCKLEY",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-808-4486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "advancedmd.com",
            "affiliation": "N",
            "endpointDescription": "advancedmd.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9706 S 230th Pl",
            "city": "Kent",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980312728",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "advancedmd.com",
            "affiliation": "N",
            "endpointDescription": "advancedmd.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9706 S 230th Pl",
            "city": "Kent",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980312728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Roka Foot and Ankle Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacqlyn Jackson
• Jelani Leif Jackson, MSW, LICSW
• Breana Jacobs
• Murray Jacobs
• Joshua William Jacobson, PT
• Jacy C Nelson D.D.S., P.S.
• Jade Chiropractic and Wellness Center
• Hannah Jaggers, MD
• Deega Jama, RN
• James Hu, DMD, PLLC

• Foot & Ankle Surgery Podiatrist in Renton, WA
• Providers in Renton, WA by specialty
• Foot & Ankle Surgery Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.