Individual provider Active NPI

Buckley Parker, P.A.-C

  • Physician Assistant
  • Memphis, TN
National Provider Identifier
1700266558
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2797 Issued in TN
Practice address
1455 Union Ave.
Memphis, TN 38104-6727
Phone
(901) 726-6655
Fax
(901) 666-8437
NPI assigned
Jun 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2797 TN Primary

Addresses

Primary practice location

1455 Union Ave.
Memphis, TN 38104-6727

Mailing address

1455 Union Ave.
Memphis, TN 38104-6727
Phone (901) 726-6655

Other practice location 1

795 Ridge Lake Blvd
Memphis, TN 38120-9475
Phone (901) 726-6655

Other identifiers 1

IdentifierTypeStateIssuer
Q014229MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20150827002364 TN Practitioner - Physician Assistant 1153637780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memphis Dermatology Clinic PAGroup PAC ID 2264507524, 11 clinicians

Practice addresses (Care Compare)

1455 Union Ave
Memphis, TN 38104-6727
Phone (901) 726-6655

795 Ridge Lake Blvd
Suite 200
Memphis, TN 38120-9475
Phone (901) 726-6655

Merit-based Incentive Payment System (MIPS)

Final score
98.41 of 100Reported as individual
Quality
96.83
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2797TNMDChiropractor

Interoperability endpoints

  • Direct secure messaging: bparker@memphisdermclinic.emadirect.md

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": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1700266558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 UNION AVE.",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046727",
            "telephone_number": "901-726-6655",
            "fax_number": "901-666-8437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 UNION AVE.",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046727",
            "telephone_number": "901-726-6655",
            "fax_number": "901-666-8437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "795 Ridge Lake Blvd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381209475",
            "country_code": "US",
            "telephone_number": "901-726-6655",
            "fax_number": "901-666-8437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "BUCKLEY",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q014229",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.