Active NPI
Patricia A Buckley, P.T.
- Physical Therapist
- Bloomington, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.007749
- Practice address
- 1111 Trinity Lane
Suite 111
Bloomington, IL 61704-3738 - Phone
- (309) 663-6461
- Fax
- (309) 661-8107
- NPI assigned
- Nov 8, 2011
- Last updated
- Oct 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.007749 | IL | Primary |
Addresses
Primary practice location
1111 Trinity Lane
Suite 111
Bloomington, IL 61704-3738
Mailing address
1111 Trinity Lane
Suite 111
Bloomington, IL 61704-3738
Phone (309) 663-6461
Other names 1
- Miss Patricia A Hilliard
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
117 N Western Ave
Peoria, IL 61604-5650
Phone (309) 674-2400
7108 Marine Rd
Edwardsville, IL 62025-4282
Phone (618) 706-9759
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.007749 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empowerme Wellness Kansas City, LLC | Physical Therapist | Current | Accepting new patients |
| Empowerme Wellness Kansas City, LLC | Current | Accepting new patients | |
| Empowerme Rehabilitation Illinois, LLC | Physical Therapist | Current | Accepting new patients |
| Empowerme Rehabilitation Illinois, LLC | Physical Therapist | Current | Accepting new patients |
Locations
1021 W E St
Belleville, IL 62220
Phone (618) 233-2095
7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759
1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723
Organizations & group practices 5
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.
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IL
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477008000000",
"number": "1740567452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 TRINITY LANE",
"address_2": "SUITE 111",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617043738",
"telephone_number": "309-663-6461",
"fax_number": "309-661-8107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 TRINITY LANE",
"address_2": "SUITE 111",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617043738",
"telephone_number": "309-663-6461",
"fax_number": "309-661-8107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKLEY",
"first_name": "PATRICIA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-08",
"last_updated": "2016-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.007749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PATRICIA",
"last_name": "HILLIARD",
"middle_name": "A",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.