Active NPI
Kristen Broadway Buchner, PT
- Pediatric Physical Therapist
- Montgomery, AL
National Provider Identifier
1639104938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PTH3856
- Practice address
- 42ND Medical Group
300 S. Twining Street
Montgomery, AL 36112 - Phone
- (334) 953-4415
- Fax
- (334) 953-6646
- NPI assigned
- Jul 12, 2006
- Last updated
- Apr 26, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH3856 | AL | |
| Pediatric Physical Therapist | 2251P0200X | PTH3856 | AL | Primary |
Addresses
Primary practice location
42ND Medical Group
300 S. Twining Street
Montgomery, AL 36112
Mailing address
300 Twining St BLDG 760
Montgomery, AL 36112-6027
Phone (334) 953-4415
Other practice location 1
40 Wisteria Place
Millbrook, AL 36054-1849
Phone (334) 285-0239
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 515-33661 | Other | AL | BLUE CROSS BLUE SHEILD |
| 51533661 | Other | AL | BCBS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTH3856 | AL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524700800000",
"number": "1639104938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 TWINING ST BLDG 760",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361126027",
"telephone_number": "334-953-4415",
"fax_number": "334-953-6646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42ND MEDICAL GROUP",
"address_2": "300 S. TWINING STREET",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "36112",
"telephone_number": "334-953-4415",
"fax_number": "334-953-6646"
}
],
"practiceLocations": [
{
"address_1": "40 Wisteria Place",
"address_purpose": "LOCATION",
"city": "Millbrook",
"state": "AL",
"postal_code": "360541849",
"country_code": "US",
"telephone_number": "334-285-0239",
"fax_number": "334-285-9689",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUCHNER",
"first_name": "KRISTEN",
"middle_name": "BROADWAY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2018-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH3856",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "AL",
"license": "PTH3856",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD",
"identifier": "515-33661",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "51533661",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.