Individual provider Active NPI

Cailie A Buckingham, R.D.

  • Registered Dietitian
  • Bellingham, WA
National Provider Identifier
1962554972
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI60455187 Issued in WA
Practice address
1345 King St
Bellingham, WA 98229-6223
Phone
(360) 676-1696
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2624 MN
Registered Dietitian 133V00000X DI60455187 WA Primary

Addresses

Primary practice location

1345 King St
Bellingham, WA 98229-6223

Mailing address

1345 King St
Bellingham, WA 98229-6223
Phone (360) 676-1696

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)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
DI60455187WAMDRegistered Dietitian
2624MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Associates PastSince Sep 14, 2020 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1250/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1962554972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 KING ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982296223",
            "telephone_number": "360-676-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 KING ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982296223",
            "telephone_number": "360-676-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKINGHAM",
        "first_name": "CAILIE",
        "middle_name": "A",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "2624",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60455187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.