Active NPI
Ernest W Bueche II, ATC
- Athletic Trainer
- Jackson, MS
National Provider Identifier
1922350602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- ATO614
- Practice address
- 1325 E Fortification St
Jackson, MS 39202-2442 - Phone
- (601) 949-9140
- NPI assigned
- Oct 5, 2012
- Last updated
- Oct 5, 2012
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | ATO614 | MS | Primary |
Addresses
Primary practice location
1325 E Fortification St
Jackson, MS 39202-2442
Mailing address
PO Box 355
Goodman, MS 39079-0355
Phone (225) 937-1295
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 |
|---|---|---|---|
| ATO614 | MS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349395200000",
"number": "1922350602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 355",
"city": "GOODMAN",
"state": "MS",
"postal_code": "390790355",
"telephone_number": "225-937-1295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 E FORTIFICATION ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392022442",
"telephone_number": "601-949-9140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUECHE",
"first_name": "ERNEST",
"middle_name": "W",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-05",
"last_updated": "2012-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "ATO614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.