Active NPI
Kerry Louise Buckley, M.D.
- Obstetrics & Gynecology Physician
- Jacksonville, FL
National Provider Identifier
1801117171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD0000048093
- Practice address
- 2080 Child St
Jacksonville, FL 32214-5005 - Phone
- (904) 542-7419
- Fax
- (904) 542-7839
- NPI assigned
- Jun 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | MD0000048093 | TN | Primary |
Addresses
Primary practice location
2080 Child St
Jacksonville, FL 32214-5005
Mailing address
236 N Bridge Creek Dr
St Johns, FL 32259-8882
Phone (301) 537-1680
Other practice location 1
Naval Hospital Guantanamo Bay
PSC 1005 Box 110185
Fpo, AA 34009
Phone (757) 458-2171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787184000000",
"number": "1801117171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "236 N BRIDGE CREEK DR",
"city": "ST JOHNS",
"state": "FL",
"postal_code": "322598882",
"telephone_number": "301-537-1680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2080 CHILD ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322145005",
"telephone_number": "904-542-7419",
"fax_number": "904-542-7839"
}
],
"practiceLocations": [
{
"address_1": "Naval Hospital Guantanamo Bay",
"address_2": "PSC 1005 Box 110185",
"address_purpose": "LOCATION",
"city": "FPO",
"state": "AA",
"postal_code": "34009",
"country_code": "US",
"telephone_number": "757-458-2171",
"country_name": "United States",
"address_type": "MIL"
}
],
"basic": {
"last_name": "BUCKLEY",
"first_name": "KERRY",
"middle_name": "LOUISE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-21",
"last_updated": "2026-08-20",
"certification_date": "2026-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "TN",
"license": "MD0000048093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.