Active NPI
Michelle Rene Bucknor, M.D.
- Pediatrics Physician
- Raleigh, NC
National Provider Identifier
1841256039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 04-24685
- Practice address
- 1011 Rock Quarry Rd
Raleigh, NC 27610-3825 - Phone
- (919) 833-3111
- Fax
- (919) 834-3118
- NPI assigned
- Apr 25, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 104778 | KS | |
| Pediatrics Physician | 208000000X | 04-24685 | KS | Primary |
| Pediatrics Physician | 208000000X | 2015-01972 | NC |
Addresses
Primary practice location
1011 Rock Quarry Rd
Raleigh, NC 27610-3825
Mailing address
1001 Rock Quarry Rd
Raleigh, NC 27610-3825
Phone (919) 833-3111
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100147720B | Medicaid | KS | |
| 2015-01972 | Other | NC | MEDICAL LICENSE |
Other names 1
- Michelle Rene Hill
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104778 | KS | MD | Pediatrics Physician |
| 2015-01972 | NC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1841256039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 ROCK QUARRY RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276103825",
"telephone_number": "919-833-3111",
"fax_number": "919-834-3118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 ROCK QUARRY RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276103825",
"telephone_number": "919-833-3111",
"fax_number": "919-834-3118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKNOR",
"first_name": "MICHELLE",
"middle_name": "RENE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-25",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KS",
"license": "104778",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KS",
"license": "04-24685",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2015-01972",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100147720B",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "2015-01972",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MICHELLE",
"last_name": "HILL",
"middle_name": "RENE",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.