Michael David Bucknell, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2091 Issued in AL

Practice address

7921 Tanner Williams Rd
Suite B
Mobile, AL 36608-8308

Phone

(251) 607-0040

Fax

(251) 607-7202

NPI assigned

Mar 15, 2007

Last updated

Aug 29, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2004

Medicare assignment

May accept Medicare assignment

Group practices

Liberation Chiropractic and Wellness PCGroup PAC ID 5395824650, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Liberation Chiropractic & Wellness, P.C.

  • Chiropractor
  • Mobile, AL
  • NPI 1952789208
  Medicare reassignment Care Compare group Authorized official
• South Alabama Chiropractic P.C.

  • Chiropractor
  • Mobile, AL
  • NPI 1013117969
  Authorized official Same address or phone

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1578697207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7921 TANNER WILLIAMS RD",
            "address_2": "SUITE B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366088308",
            "telephone_number": "251-607-0040",
            "fax_number": "251-607-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7921 TANNER WILLIAMS RD",
            "address_2": "SUITE B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366088308",
            "telephone_number": "251-607-0040",
            "fax_number": "251-607-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNELL",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529922410",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIVAHEALTH PROVIDER NUM",
            "identifier": "Z02058",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSPRING PROVIDER NUM",
            "identifier": "V06119",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009983115",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS UPIN",
            "identifier": "#01465",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "51523710",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Buchanan, MD
• Peyton Riley Buck
• Alyson Nicole Buckley, MSN,APRN, FNP-C
• Keith D Buckley, CRNA
• Ralph Stowell Buckley, MD
• Ahzam Budhwani
• Thomas Ryan Buerkert, MD
• James R. Buettner, RPH
• Dreshun Buford
• Christopher Minh Bui

• Chiropractor in Mobile, AL
• Providers in Mobile, AL by specialty
• Chiropractor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.