Individual provider Active NPI

Zachary D Buckland, FNP-C

  • Family Medicine Physician
  • Idaho Falls, ID
National Provider Identifier
1629893177
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6671238 Issued in ID
Practice address
2001 S Woodruff Ave Ste 15B
Idaho Falls, ID 83404-6372
Phone
(208) 357-4633
NPI assigned
Nov 19, 2024
Last updated
Dec 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6671238 ID Primary

Addresses

Primary practice location

2001 S Woodruff Ave Ste 15B
Idaho Falls, ID 83404-6372

Mailing address

4137 E 132 N
Rigby, ID 83442-5813
Phone (208) 570-7944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20250113002382 ID Practitioner - Nurse Practitioner 5395273767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medicine Hub PLLCGroup PAC ID 9537422662, 6 clinicians

Practice addresses (Care Compare)

2001 S Woodruff Ave
Suite 15B
Idaho Falls, ID 83404-6372
Phone (208) 357-4633

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6671238IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine Hub PLLC CurrentSince Dec 30, 2024 Accepting new patients
Flower Aston Nutrition LLC CurrentSince Nov 24, 2024 Accepting new patients

Locations

2001 S Woodruff Ave
Ste 15B
Idaho Falls, ID 83404
Phone (208) 357-4633

Interoperability endpoints

  • Direct secure messaging: zachary.buckland.1@19202.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1629893177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4137 E 132 N",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834425813",
            "telephone_number": "208-570-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE STE 15B",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046372",
            "telephone_number": "208-357-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLAND",
        "first_name": "ZACHARY",
        "middle_name": "D",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "6671238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.