Ronnie Dean Buckingham

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2003017636 Issued in MO

Practice address

1 Southtowne Dr
Potosi, MO 63664-5729

Phone

(573) 438-9355

NPI assigned

Jan 30, 2026

Last updated

Mar 4, 2026By 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 1

Addresses

Other names 1

• Mr. Ronnie D Buckingham Jr. Other name

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Mines Health CenterGroup PAC ID 3072598143, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Great Mines Health Center

  • Federally Qualified Health Center (FQHC)
  • Potosi, MO
  • NPI 1376536953
  Medicare reassignment Care Compare group NPD (past)
• Great Mines Health Center

  dba Farmington R-VII - Dayse Baker Learning Center

  • Federally Qualified Health Center (FQHC)
  • Farmington, MO
  • NPI 1073188462
  NPD
• Great Mines Health Center

  • Federally Qualified Health Center (FQHC)
  • Farmington, MO
  • NPI 1922446384
  NPD

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

{
    "created_epoch": "1769731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1609726504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W JEFFERSON ST",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636641830",
            "telephone_number": "314-226-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SOUTHTOWNE DR",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636645729",
            "telephone_number": "573-438-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKINGHAM",
        "first_name": "RONNIE",
        "middle_name": "DEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2003017636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RONNIE",
            "last_name": "BUCKINGHAM",
            "middle_name": "D",
            "prefix": "MR.",
            "suffix": "JR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Timothy Will Christopher Bass, M.D.
• Kallie Belfield
• Mackenzie Bennett
• Melissa Gail Benson, LMSW
• Christine Marie Black, MSW LCSW
• David Burke, PTA
• Jason D. Butler, FNP
• Linda D Butler, RN, BC, FNP
• Mark Byerley
• Allayna Campbell

• Family Nurse Practitioner in Potosi, MO
• Providers in Potosi, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.