Alexander Robert-Charles Buskill, NP
Individual provider Active NPI Nurse Practitioner · Norton, VA
NPI 1740940147 · NPPES record last updated Feb 26, 2024
Key facts
- NPI
- 1740940147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 111616 (WV)
- Practice address
- 1490 Park Ave NW Ste 4B
Norton, VA 24273-1631 - Phone
- (276) 439-1385
- NPI assigned
- Dec 27, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220831000314 | WV | Practitioner - Nurse Practitioner | 1355725920 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111616 | WV | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beautiful Minds Counseling Center | Current |
Accepting new patients |
Locations
108 Morrison Dr
Princeton, WV 24740
Phone (681) 282-5678
Interoperability endpoints
- abuskill28213@carelonhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0024183305 | VA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 0024183305 | VA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 111616 | WV | |
| Nurse Practitioner | 363L00000X | 111616 | WV | Yes |
Addresses
Primary practice location
1490 Park Ave NW Ste 4B
Norton, VA 24273-1631
Mailing address
1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565
Other practice location 1
108 Morrison Dr
Princeton, WV 24740-2322
Phone (681) 282-5678
Other practice location 2
1980 Holton Ave E Ste 203
Big Stone Gap, VA 24219-3367
Phone (276) 523-8865
Other practice location 3
743 Island Rd
Bristol, VA 24201-7403
Phone (276) 469-4200
Other practice location 4
1490 Park Ave NW Ste 4C
Norton, VA 24273-1631
Phone (276) 439-1385
Other practice location 5
671 Highway 58 E
Norton, VA 24273-3007
Phone (276) 679-5874
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | abuskill176207@balladhealth.medalliesdirect.net | Direct | Norton Community Physician Services LLC |
Other providers in Norton, VA
- Phyllis Brummitte
- Christopher Lynn Bruner
- Carrie Ann Burke
- Douglas E Burke III
- Lauren Burns
- James Wesley Campbell
- Elpidio Capalad
- Kim Carter
- Cavalier Pharmacy 2 Inc
- Chestnut Physician Services LLC
All providers in Norton, VA · Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.