Robert Buzan, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4950 Issued in NC

Practice address

6811 Buckley Dr
Summerfield, NC 27358-9785

Phone

(828) 278-3722

Fax

(833) 420-1616

NPI assigned

Sep 30, 2016

Last updated

Feb 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1609325679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 BATTLEGROUND AVE STE 112-305",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274108575",
            "telephone_number": "828-278-3722",
            "fax_number": "833-420-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6811 BUCKLEY DR",
            "city": "SUMMERFIELD",
            "state": "NC",
            "postal_code": "273589785",
            "telephone_number": "828-278-3722",
            "fax_number": "833-420-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUZAN",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-30",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "4950",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NC",
            "license": "4950",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4950",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609325679",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Summerfield, NC
• Providers in Summerfield, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.