Individual provider Active NPI

Emily Buckley, CRNA

  • Certified Registered Nurse Anesthetist
  • Springfield, IL
National Provider Identifier
1730577586
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
000000000 Issued in IL
Practice address
800 E Carpenter St
Springfield, IL 62702-5324
Phone
(217) 525-5643
Fax
(217) 544-2521
NPI assigned
Jan 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 000000000 IL Primary

Addresses

Primary practice location

800 E Carpenter St
Springfield, IL 62702-5324

Mailing address

800 E Carpenter St
Springfield, IL 62702-5324
Phone (217) 525-5643

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150610000632 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315268737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 W 10TH St
Phelps Health
Rolla, MO 65401-2905
Phone (573) 458-8899

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
000000000ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Phelps County Regional Medical Center CurrentSince May 5, 2015 Accepting new patients
Phelps County Regional Medical Center CurrentSince May 5, 2015 Accepting new patients

Locations

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

Organizations & group practices 2

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

Hospital & facility affiliations 3

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": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1730577586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025324",
            "telephone_number": "217-525-5643",
            "fax_number": "217-544-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025324",
            "telephone_number": "217-525-5643",
            "fax_number": "217-544-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "EMILY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-02",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.