Connie Buck, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201901366NP-PP Issued in OR

Practice address

1010 SW Coast Hwy Ste 203
Newport, OR 97365-5215

Phone

(541) 265-4947

Fax

(541) 574-7670

NPI assigned

Aug 24, 2015

Last updated

Oct 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Wyoming Behavioral Institute

  • Psychiatric Hospital
  • Casper, WY
  • NPI 1295709822
  Medicare reassignment NPD
• Cedars Health

  • Primary Care Clinic/Center
  • Casper, WY
  • NPI 1306196209
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1760859995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 E BARNETT RD STE H",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048383",
            "telephone_number": "541-789-8176",
            "fax_number": "541-778-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SW COAST HWY STE 203",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973655215",
            "telephone_number": "541-265-4947",
            "fax_number": "541-574-7670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Crestline Drive",
            "address_purpose": "LOCATION",
            "city": "Waldport",
            "state": "OR",
            "postal_code": "97394",
            "country_code": "US",
            "telephone_number": "541-265-0471",
            "fax_number": "541-265-0566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 NE Sturdevant Rd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OR",
            "postal_code": "973912413",
            "country_code": "US",
            "telephone_number": "541-265-0473",
            "fax_number": "541-336-7658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCK",
        "first_name": "CONNIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "15987-1395",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "99694",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201901366NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betsy Jean Brooks, RN, LMT
• Jenny Brosi
• Jason E Brown, PAC
• Katja Brown, QMHA
• Kelli Ann Brugh, LCSW
• Kenneth Mark Builder, DMD
• Brent D. Bunker, CRNA
• Karen Fleenor Bunn, M.D.
• Lauren Morrison Burns, RD, LD
• Stephen M. Burns, MD

• Family Nurse Practitioner in Newport, OR
• Providers in Newport, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; 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.