Scott M. Buckingham, OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

003193 Issued in MI

Legal business name

SCOTT M. BUCKINGHAM, OD PC

Practice address

2808 W Wackerly St
Suite 1
Midland, MI 48640-6997

Phone

(989) 636-7580

Fax

(989) 636-7583

NPI assigned

Nov 20, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Jeri L Overly, ABOC, NAO

Title

Office Manager

Phone

(989) 636-7580

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy Lou Buchanan, OD

  • Optometrist
  • Grand Rapids, MI
  • NPI 1922209451
  Medicare reassignment Care Compare group NPD
• John Earl Kaminski, OD

  • Optometrist
  • Midland, MI
  • NPI 1003811605
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1790966646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 W WACKERLY ST",
            "address_2": "SUITE 1",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406997",
            "telephone_number": "989-636-7580",
            "fax_number": "989-636-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 W WACKERLY ST",
            "address_2": "SUITE 1",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406997",
            "telephone_number": "989-636-7580",
            "fax_number": "989-636-7583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT M. BUCKINGHAM, OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "OVERLY",
        "authorized_official_first_name": "JERI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-636-7580",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ABOC, NAO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "003193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "900E611320",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisha Rose Schuman
• Leslie K Schutz, MD
• Leann Schwedler
• Katherine Schweim
• Shelly Schwerin
• Scott W. Trylch
• Scott W. Zimostrad, PH.D., P.C.
• Agnes Marie Scott, MSW
• Brandon Scott
• Gerald K Scott, MA, LLPC

• Optometrist in Midland, MI
• Providers in Midland, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.

Verify at the official NPI Registry.