Shawn Buckles
Individual provider Active NPI Specialist · Kansas City, MO
NPI 1720148737 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720148737
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 000252 (MO)
- Practice address
- 1211 McGee St
Room 905-C
Kansas City, MO 64106-2416 - Phone
- (816) 418-7840
- Fax
- (816) 418-1807
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000252 | MO | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 000252 | MO | Yes |
Addresses
Primary practice location
1211 McGee St
Room 905-C
Kansas City, MO 64106-2416
Mailing address
1211 McGee St
Room 905-C
Kansas City, MO 64106-2416
Phone (816) 418-7840
Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.