Individual provider Active NPI

Andrew Madison Buckelew, DO

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Atlanta, GA
National Provider Identifier
1801355607
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
99101 Issued in GA
Practice address
1001 Johnson Ferry Rd
Atlanta, GA 30342-1605
Phone
(678) 344-1960
Fax
(404) 785-9168
NPI assigned
Mar 19, 2019
Last updated
Jun 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 99101 GA
Pediatrics Physician 208000000X OS18983 FL
Pediatrics Physician 208000000X 30451 MS
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 99101 GA Primary

Addresses

Primary practice location

1001 Johnson Ferry Rd
Atlanta, GA 30342-1605

Mailing address

1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605
Phone (678) 344-1960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, MS3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230622003270 FL Practitioner - Pediatric Medicine 1850759804 Reassigns benefits to 1 organization
I20240813003939 GA Practitioner - Pediatric Medicine 1850759804 Reassigns benefits to 2 organizations
I20240927003082 MS Practitioner - Pediatric Medicine 1850759804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Practice addresses (Care Compare)

2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117
Phone (404) 785-5437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS18983FLMDPediatrics Physician
99101GAMDPediatrics Physician
30451MSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Jun 15, 2023 Accepting new patients
Singing River Health System CurrentSince Sep 30, 2024 Accepting new patients
Singing River Health System CurrentSince Sep 30, 2024 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 1, 2024 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 1, 2024 Accepting new patients
Emergency Group of Columbus, LLC CurrentSince Jul 5, 2024 Accepting new patients
Sacred Heart Health System Inc CurrentSince Jun 15, 2023 Accepting new patients
Emergency Coverage, LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

1657 Trinity Dr
Pensacola, FL 32504
Phone (850) 416-2400

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

2220 N Druid Hills Rd NE
Brookhaven, GA 30329
Phone (404) 778-1440

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2500 N State St
#S148A
Jackson, MS 39216

1199 Ocean Springs Rd
Ocean Springs, MS 39564
Phone (228) 875-9363

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

Interoperability endpoints

  • Direct secure messaging: abuckelew177664@ummc.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1801355607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421605",
            "telephone_number": "678-344-1960",
            "fax_number": "404-907-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FERRY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421605",
            "telephone_number": "678-344-1960",
            "fax_number": "404-785-9168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKELEW",
        "first_name": "ANDREW",
        "middle_name": "MADISON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2025-06-06",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "99101",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS18983",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "30451",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "GA",
            "license": "99101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.