NPIMap

Individual provider Active NPI

Jill Dee Buck, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Anaconda, MT
National Provider Identifier
1720711567
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NUR-APRN-LIC-196243 Issued in MT
Practice address
606 E Park Ave
Anaconda, MT 59711-2469
Phone
(406) 563-7962
NPI assigned
Jul 8, 2022
Last updated
Jul 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NUR-APRN-LIC-196243 MT Primary

Addresses

Primary practice location

606 E Park Ave
Anaconda, MT 59711-2469

Mailing address

713 Stewart St
Anaconda, MT 59711-9330
Phone (406) 560-9101

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mrpalmer@reiterfoundation.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221006003404 MT Practitioner - Nurse Practitioner 7517343023 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aware IncGroup PAC ID 4284529348, 15 clinicians

Practice addresses (Care Compare)

205 E Park Ave
Anaconda, MT 59711-2340
Phone (406) 563-8117

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-196243MTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Ehr Collaborative Inc. CurrentSince Oct 1, 2022 Accepting new patients
Aware Inc CurrentSince Dec 8, 2022 Accepting new patients
Reiter Foundation PastSince Jul 10, 2022 Accepting new patients

Locations

205 E Park Ave
Anaconda, MT 59711
Phone (406) 563-8117

606 E Park Ave
Anaconda, MT 59711
Phone (406) 563-7962

Interoperability endpoints

  • Direct secure messaging: mrpalmer@reiterfoundation.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1720711567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 STEWART ST",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597119330",
            "telephone_number": "406-560-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 E PARK AVE",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597112469",
            "telephone_number": "406-563-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "JILL",
        "middle_name": "DEE",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MT",
            "license": "NUR-APRN-LIC-196243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrpalmer@reiterfoundation.org",
            "affiliation": "N",
            "endpointDescription": "E mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "606 E Park Ave",
            "city": "Anaconda",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597112469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anaconda, MT

Sources for this page

Verify at the official NPI Registry.