Individual provider Active NPI

Rachel R Buck, FNP-C

  • Family Nurse Practitioner
  • Wiley, CO
National Provider Identifier
1629451091
Registry record updated Sep 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0991747-NP Issued in CO
Practice address
36053 US Highway 287
Wiley, CO 81092-9702
Phone
(719) 829-4030
NPI assigned
Jul 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0991747-NP CO Primary

Addresses

Primary practice location

36053 US Highway 287
Wiley, CO 81092-9702

Mailing address

36053 US Highway 287 Ste 208
Wiley, CO 81092-9702
Phone (719) 829-4030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20160620001132 CO Practitioner - Nurse Practitioner 1254622483 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.0991747-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County Line Health Clinic Family CurrentSince Jul 3, 2023 Accepting new patients

Locations

36053 US Highway 287
Ste 208
Wiley, CO 81092

36053 US Highway 287
Wiley, CO 81092
Phone (719) 468-6395

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24285/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1435881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696032000000",
    "number": "1629451091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36053 US HIGHWAY 287 STE 208",
            "city": "WILEY",
            "state": "CO",
            "postal_code": "810929702",
            "telephone_number": "719-829-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36053 US HIGHWAY 287",
            "city": "WILEY",
            "state": "CO",
            "postal_code": "810929702",
            "telephone_number": "719-829-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "RACHEL",
        "middle_name": "R",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-03",
        "last_updated": "2023-09-30",
        "certification_date": "2023-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0991747-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wiley, CO

Sources for this page

Verify at the official NPI Registry.