Jacob D Buckley, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

ARNP9257640 Issued in FL

Practice address

1 Hospital Dr SW
Huntsville, AL 35801-6455

Phone

(256) 429-5074

Fax

(256) 429-4674

NPI assigned

Jan 19, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, AL, KY, VA, IN5 enrollments

Enrollment records 5

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physynergy LLCGroup PAC ID 6204081292, 51 clinicians

Professional Anesthesia Services of Kentucky PLLCGroup PAC ID 0244590305, 351 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Crestwood Medical Center Hospital, Huntsville, AL, CCN 010131
• Baptist Health Louisville Hospital, Louisville, KY, CCN 180130

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Physynergy, LLC

  • Anesthesiology Physician
  • Huntsville, AL
  • NPI 1134465560

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Professional Anesthesia Services of Kentucky PLLC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1992212807

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Epix Anesthesia of Alabama LLC

  • Anesthesiology Physician
  • Roswell, GA
  • NPI 1629427059

  AL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northstar Anesthesia of Florida LLC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1568056166

  FL

  Medicare reassignment NPD
• Northstar Anesthesia of Virginia, LLC

  • Anesthesiology Physician
  • Alexandria, VA
  • NPI 1194488791
  Medicare reassignment NPD
• Northstar Anesthesia of Indiana LLC

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1043561541

  IN

  Medicare reassignment
• Physynergy, LLC

  • Anesthesiology Physician
  • Mobile, AL
  • NPI 1093173502

  Nurse Anesthetist, Certified Registered

  NPD
• Physynergy, LLC

  • Anesthesiology Physician
  • Shelbyville, TN
  • NPI 1124455969

  Nurse Anesthetist, Certified Registered

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Crestwood Healthcare LP

  • General Acute Care Hospital
  • Huntsville, AL
  • NPI 1023061496
  Care Compare affiliation
• Baptist Healthcare System Inc.

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1265539498
  Care Compare affiliation

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1598036865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52404",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705052404",
            "telephone_number": "256-429-5071",
            "fax_number": "256-429-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016455",
            "telephone_number": "256-429-5074",
            "fax_number": "256-429-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "JACOB",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-19",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9257640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE",
            "identifier": "ARNP9257640",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA CRNA LICENSE",
            "identifier": "1-136658",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydney McGuire Buchan, MA, ALC
• Buchanan & Tipton LLC
• Amanda Gayle Buchanan
• Thomas Buchanan, MSW
• Thomas Buchholz, CO
• James George Buckley, D.D.S., M.D.
• Steven L Buckley, MD
• Talia L Buckley, CRNA
• Buckner Chiropractic Center, Inc.
• Schuyler Buckner, DPT

• Certified Registered Nurse Anesthetist in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Certified Registered Nurse Anesthetist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.