Organization Active NPI

Matthew G. Buxton, M.D., PA

Doing business as Free State Dermatology

  • Dermatology Physician
  • Lawrence, KS
National Provider Identifier
1730396680
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
04-26254 Issued in KS
Legal business name
MATTHEW G. BUXTON, M.D., PA
Doing business as
Free State Dermatology
Practice address
3511 Clinton PL
Lawrence, KS 66047-2196
Phone
(785) 749-7546
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Matthew G Buxton, M.D.NPI 1063410488
Title
President
Phone
(785) 749-7546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 04-26254 KS Primary

Addresses

Primary practice location

3511 Clinton PL
Lawrence, KS 66047-2196

Mailing address

3511 Clinton PL
Lawrence, KS 66047-2196

Other names 1

  • Free State Dermatology Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D1022711Free State Dermatology3511 Clinton Place, Lawrence, KS 66047Provider-performed microscopyFeb 23, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730396680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 CLINTON PL",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660472196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 CLINTON PL",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660472196",
            "telephone_number": "785-749-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW G. BUXTON, M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUXTON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "785-749-7546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "KS",
            "license": "04-26254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Free State Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.