Kevin W Bueckman, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

KB004130 Issued in MI

Practice address

653 36TH St SW
Wyoming, MI 49509-4004

Phone

(616) 530-0085

Fax

(616) 531-5029

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1710001896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 NORTH SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169407",
            "telephone_number": "616-891-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 36TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495094004",
            "telephone_number": "616-530-0085",
            "fax_number": "616-531-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUECKMAN",
        "first_name": "KEVIN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "KB004130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "950 D1 5107",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN PROVIDER ID",
            "identifier": "P52560",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2117924",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristian Ricardo Craciun Brutten, DDS
• Gail K Bryan-Besteman, M.D.
• David Bryska, MD
• Olivia Buckley
• Erik Budz, PA-C
• Tyler Lee Buffin
• Angela Buggs, CHW
• Janette R Buhl, NP
• Robert Bulten, M.D.
• Michael J Bultje, DO

• Chiropractor in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.