Merrick Buckingham

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA2010-0054 Issued in NM

Practice address

1001 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87106-4713

Phone

(505) 925-6000

Fax

(505) 925-7849

NPI assigned

Apr 26, 2007

Last updated

Mar 22, 2017By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1659591279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE",
            "address_2": "SUITE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064374",
            "telephone_number": "505-272-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 DR MARTIN LUTHER KING JR AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064713",
            "telephone_number": "505-925-6000",
            "fax_number": "505-925-7849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKINGHAM",
        "first_name": "MERRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "18180",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "PA2010-0054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Buck, LPCC
• Marjorie Helen Buck, RNCS
• Wendy Denise Buckels, MS, CCC-SLP
• Buckeye Therapeutics and Mediation, LLC
• Carly Paige Buckingham, D.O.
• Jason Buckles, LPCC
• Ariel Buckner
• Alicia Danielle Bucko, DO
• Jana Buckwalter
• Eleni Marie Bucuvalas, M.D.

• Surgical Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Surgical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.