Diane L Buckley, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

288027 Issued in WI

Practice address

80 1St St
Prairie Du Sac, WI 53578-1550

Phone

(608) 643-7263

Fax

(608) 643-7667

NPI assigned

Jan 15, 2007

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780735019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N2699 WILSON RD",
            "city": "POYNETTE",
            "state": "WI",
            "postal_code": "539559564",
            "telephone_number": "608-643-7263",
            "fax_number": "608-643-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 1ST ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535781550",
            "telephone_number": "608-643-7263",
            "fax_number": "608-643-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "DIANE",
        "middle_name": "L",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "288027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Elizabeth Bixby, APNP
• Samantha Jo Boll, PT, DPT
• Kelsey M Brady, MSW, LCSW
• Becki Jo Braund, PT
• Brigitta M D Brickl
• Mackenzie Lynn Bugg
• Emily M Campbell, LPC
• Sandra Carroll, CRNA
• Alicia Christine Castillo, FNP
• Kelly Chernik, OTR

• All providers in Prairie Du Sac, WI
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.