Kevin Stuart Buckley, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2009-01048 Issued in NC

Practice address

1001 Blythe Blvd
Medical Center Plaza Suite 200
Charlotte, NC 28203-5866

Phone

(704) 381-8840

NPI assigned

Aug 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Specialty

Pediatric MedicineAlso: Hematology/Oncology, Infectious Disease

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94 of 100Reported as apm

Quality

81.63

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbuckley485182@carolinashealthcaresystem.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carolinas Medical Center

  dba Atrium Health Levine Children's Gastroenterology

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1275774333

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Carolinas Medical Center

  dba Atrium Health Pulmonary University

  • Surgical Critical Care Physician
  • Charlotte, NC
  • NPI 1699979732

  Pediatrics

  NPD
• Carolinas Medical Center

  dba Atrium Health Pharmacy Kenilworth

  • Community/Retail Pharmacy
  • Charlotte, NC
  • NPI 1982710554
  NPD

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1811004302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD",
            "address_2": "MEDICAL CENTER PLAZA SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-381-8840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035866",
            "country_code": "US",
            "telephone_number": "704-381-9900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Blythe Blvd",
            "address_2": "Ste 500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035866",
            "country_code": "US",
            "telephone_number": "704-373-1813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 310",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-2660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4501 Cameron Valley Pkwy",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114297",
            "country_code": "US",
            "telephone_number": "704-381-1410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "KEVIN",
        "middle_name": "STUART",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NC",
            "license": "2009-01048",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NC",
            "license": "2009-01048",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2009-01048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbuckley485182@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1001 Blythe Blvd",
            "address_2": "Medical Center Plaza, Suite 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael John Buckingham, D.C.
• Ashley Buckius, MPH OTD OTR/L
• Sonja R Buckles-Smith, LCMHCS
• Cheryl Buckley, RDN, CDN , MBA , MS
• Elizabeth Atkison Buckley, CD-L
• Lashena Sharay Buckley
• Kylie Buckman, L.AC, DIPL. OM
• Buckner LTD Co
• Callie Reed Buckner, LCSWA
• Kimberly Beth Buckner, DNP

• Pediatrics Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.
• 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.