Active NPI
Brian Buckingham
- Physician Assistant
- Neah Bay, WA
National Provider Identifier
1679900922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PC60387753
- Practice address
- 100 Wellness Way
Box 410
Neah Bay, WA 98357 - Phone
- (360) 645-2075
- NPI assigned
- Oct 2, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | CM60387748 | WA | |
| Physician Assistant | 363A00000X | PC60387753 | WA | Primary |
Addresses
Primary practice location
100 Wellness Way
Box 410
Neah Bay, WA 98357
Mailing address
100 Wellness Way
Box 410
Neah Bay, WA 98357
Phone (360) 645-2075
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CM60387748 | WA | MD | Physician Assistant |
| PC60387753 | WA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380672000000",
"number": "1679900922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WELLNESS WAY",
"address_2": "BOX 410",
"city": "NEAH BAY",
"state": "WA",
"postal_code": "98357",
"telephone_number": "360-645-2075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WELLNESS WAY",
"address_2": "BOX 410",
"city": "NEAH BAY",
"state": "WA",
"postal_code": "98357",
"telephone_number": "360-645-2075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKINGHAM",
"first_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-10-02",
"last_updated": "2013-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "CM60387748",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PC60387753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Neah Bay, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.