Jennifer Wilson Buck, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT020568 Issued in PA

Practice address

8015 Lawndale Street
Philadelphia, PA 19111

Phone

(215) 745-8679

NPI assigned

Jul 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Jill Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1942513858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E MERMAID LN",
            "address_2": "UNIT 211",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191183244",
            "telephone_number": "540-455-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8015 LAWNDALE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19111",
            "telephone_number": "215-745-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "JENNIFER",
        "middle_name": "WILSON",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-20",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT020568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WILSON",
            "middle_name": "JILL",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anna M Buchner, MD
• Amber Faith Buck, COTA/L
• Anne Marie Theresa Buck, M.S.
• Breona Shakeya Buck
• Eve Buck
• Jillian Buck, DPT
• Matthew Bradford Buck
• Melissa Buck, M.D.
• Eujasha Buckery
• Timothy Michael Buckey, MD

• Physical Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; 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.