Active NPI
Lisa Buckingham, CRNA
- Anesthesiology Physician
- Dayton, OH
National Provider Identifier
1821132846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 048905
- Practice address
- 1 Wyoming St
Dayton, OH 45409-2722 - Phone
- (937) 208-6173
- Fax
- (937) 208-3843
- NPI assigned
- Feb 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | RN210684 | OH | |
| Certified Registered Nurse Anesthetist | 367500000X | RN210684 | OH | |
| Anesthesiology Physician | 207L00000X | 048905 | OH | Primary |
Addresses
Primary practice location
1 Wyoming St
Dayton, OH 45409-2722
Mailing address
1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-6173
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2189671 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048905 | OH | MD | Anesthesiology Physician |
| RN210684 | OH | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588896000000",
"number": "1821132846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 WYOMING ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092722",
"telephone_number": "937-208-6173",
"fax_number": "937-208-3843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 WYOMING ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092722",
"telephone_number": "937-208-6173",
"fax_number": "937-208-3843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKINGHAM",
"first_name": "LISA",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2020-05-08",
"certification_date": "2020-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OH",
"license": "RN210684",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "RN210684",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OH",
"license": "048905",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2189671",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.