Active NPI
Nancy Hammer Buckner, COTA
- Occupational Therapy Assistant
- MC Lean, VA
National Provider Identifier
1720228489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 0131000156
- Practice address
- 1739 Kirby Rd
MC Lean, VA 22101-4817 - Phone
- (804) 506-4626
- NPI assigned
- Feb 20, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 0131000156 | VA | Primary |
| Occupational Therapy Assistant | 224Z00000X | 6032 | NC |
Addresses
Primary practice location
1739 Kirby Rd
MC Lean, VA 22101-4817
Mailing address
30065 Back Creek Rd
P O Box 61
Pungoteague, VA 23422
Phone (757) 442-1120
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 |
|---|---|---|---|
| 6032 | NC | MD | Chiropractor |
| 0131000156 | VA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235088000000",
"number": "1720228489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30065 BACK CREEK RD",
"address_2": "P O BOX 61",
"city": "PUNGOTEAGUE",
"state": "VA",
"postal_code": "23422",
"telephone_number": "757-442-1120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1739 KIRBY RD",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221014817",
"telephone_number": "804-506-4626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKNER",
"first_name": "NANCY",
"middle_name": "HAMMER",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-20",
"last_updated": "2009-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "VA",
"license": "0131000156",
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "6032",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in MC Lean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.