Roberta A Buum, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10003677 Issued in WA

Practice address

521 E Mountain View Ave
Ellensburg, WA 98926-3865

Phone

(509) 962-1414

Fax

(509) 962-1408

NPI assigned

May 20, 2006

Last updated

Jan 27, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296086400000",
    "number": "1700830155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 W LINCOLN AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022473",
            "telephone_number": "509-452-4520",
            "fax_number": "509-452-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E MOUNTAIN VIEW AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263865",
            "telephone_number": "509-962-1414",
            "fax_number": "509-962-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUUM",
        "first_name": "ROBERTA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2011-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0226463",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7118250",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Budworth, PTA
• Tristan Thomas Bueneman
• Dallin C Burnett, DMD
• Addie Burtle, MD
• Hollie Elizabeth Butler, LMP
• Chloe Elizabeth Cairns
• Edith Lucia Call
• Mary Call, LMP
• Ceri Ann Callan, MS
• Adam Camargo

• Physician Assistant in Ellensburg, WA
• Providers in Ellensburg, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.