Jessica Lynn Buckwalter

Primary specialty

DentistTaxonomy code 122300000X

License

0401417442 Issued in VA

Practice address

1111 S Jefferson St
Roanoke, VA 24016-4724

Phone

(540) 855-6800

NPI assigned

Apr 21, 2020

Last updated

Oct 7, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jbuckwalter125517@direct.carilionclinic.org

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1760002620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 MURCHIES HILL RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232343327",
            "telephone_number": "703-473-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164724",
            "telephone_number": "540-855-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKWALTER",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-21",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417442",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah C Buchholz
• Amanda Buchmeier, BCBA, LBA
• David A Buck, M.D.
• Jamie J Buck, MD
• Angela S Buckner
• Robert Earl Budin, MD
• Victoria Psimas Buehrer, OTR/L
• Kara Bui, MS
• Gregory Bull, PA-C
• Charles Monroe Bullins II, AGACNP-BC

• Dentist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.