Active NPI
Christa Buckley, MS, CCC-SLP
- Speech-Language Pathologist
- Soldotna, AK
National Provider Identifier
1629130968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 221
- Practice address
- 43335 K Beach Rd
Suite 32-a
Soldotna, AK 99669-8260 - Phone
- (907) 262-5456
- Fax
- (907) 262-5475
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 221 | AK | Primary |
Addresses
Primary practice location
43335 K Beach Rd
Suite 32-a
Soldotna, AK 99669-8260
Mailing address
805 Sand Dollar Dr # 9
Kenai, AK 99611-8818
Phone (907) 283-2699
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 143MA | Other | NC | BLUE CROSS BLUE SHIELD # |
| 7412652 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 221 | AK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223424000000",
"number": "1629130968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 SAND DOLLAR DR # 9",
"city": "KENAI",
"state": "AK",
"postal_code": "996118818",
"telephone_number": "907-283-2699",
"fax_number": "907-283-2699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43335 K BEACH RD",
"address_2": "SUITE 32-A",
"city": "SOLDOTNA",
"state": "AK",
"postal_code": "996698260",
"telephone_number": "907-262-5456",
"fax_number": "907-262-5475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKLEY",
"first_name": "CHRISTA",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2008-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AK",
"license": "221",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD #",
"identifier": "143MA",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7412652",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Soldotna, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.