Active NPI
Geoffrey Edwards Buck, PSY.D.
- Clinical Psychologist
- Indianapolis, IN
National Provider Identifier
1902362619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20040395
- Practice address
- 9245 N Meridian St # 111
Indianapolis, IN 46260-1836 - Phone
- (317) 258-6711
- NPI assigned
- Feb 18, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20040395 | IN | Primary |
Addresses
Primary practice location
9245 N Meridian St # 111
Indianapolis, IN 46260-1836
Mailing address
11249 Shoreview Cir
Indianapolis, IN 46236-8626
Phone (317) 258-6711
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20040395 | IN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550448000000",
"number": "1902362619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11249 SHOREVIEW CIR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462368626",
"telephone_number": "317-258-6711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9245 N MERIDIAN ST # 111",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462601836",
"telephone_number": "317-258-6711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCK",
"first_name": "GEOFFREY",
"middle_name": "EDWARDS",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-18",
"last_updated": "2019-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20040395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.