Sharisma Buckley

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

6907 Highway 165
Columbia, LA 71418

Phone

(318) 649-6399

NPI assigned

Jan 17, 2018

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 14, 2018.

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1912415571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6907 HIGHWAY 165",
            "city": "COLUMBIA",
            "state": "LA",
            "postal_code": "714183500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6907 HIGHWAY 165",
            "city": "COLUMBIA",
            "state": "LA",
            "postal_code": "71418",
            "telephone_number": "318-649-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "SHARISMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171M00000X",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Ben, RSW
• Bio-Medical Applications of Louisiana, LLC
• Madison Strain Black
• Dawn Blackwell
• Bethany Mitchell Braddock, APRN, FNP-C
• Caldwell Council on Aging
• Caldwell Council on Aging
• Caldwell Council on Aging
• Caldwell Council on Aging
• Caldwell Council on Aging

• All providers in Columbia, LA
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; 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.