Theresa Kassack Buchanan, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN149616 Issued in GA

Practice address

134 W Campus Dr
CBX 091
Milledgeville, GA 31061

Phone

(478) 445-5288

Fax

(478) 445-3142

NPI assigned

Feb 22, 2010

Last updated

Mar 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Gcsu Athletic Training

  • Athletic Trainer
  • Milledgeville, GA
  • NPI 1033111638
  NPD (past)
• Laboratory Corporation of America Holdings

  • Clinical Medical Laboratory
  • San Diego, CA
  • NPI 1427864081
  NPD (past)

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

{
    "created_epoch": "1266796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1902128747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 LAKE ISLAND DR",
            "city": "SPARTA",
            "state": "GA",
            "postal_code": "310875022",
            "telephone_number": "770-412-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 W CAMPUS DR",
            "address_2": "CBX 091",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "31061",
            "telephone_number": "478-445-5288",
            "fax_number": "478-445-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "THERESA",
        "middle_name": "KASSACK",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-22",
        "last_updated": "2022-03-08",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN149616",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN149616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Britt, RN, SANE-A
• Bonnie Toarmina Brooks, DPT
• Charles Frederick Brown, MD
• Haley Locklin Brown
• Vickie M Brown, MD
• Mark Bukari
• Erlyn Bullanday, DPT
• Tabbertina Bundrage
• Titus Bundrage Sr.
• Lauren Ann Burkhalter

• Family Nurse Practitioner in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.