Brian D Buckrop, DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

016003038 Issued in IL

Practice address

2102 47TH St
Moline, IL 61265-3664

Phone

(309) 797-6565

Fax

(309) 797-8586

NPI assigned

Jan 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1982674677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 47TH ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653664",
            "telephone_number": "309-797-6565",
            "fax_number": "309-797-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 47TH ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653664",
            "telephone_number": "309-797-6565",
            "fax_number": "309-797-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKROP",
        "first_name": "BRIAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IL",
            "license": "016003038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480000194",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003083",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Irene Brown, M.D.
• Larry D Brown, CRNA
• Lauren Emily Brown, PA-C
• Deanna Brumbaugh, CPHT, RN
• Heather Bruss, FNP-C
• Becki Buescher, DC
• Carissa A Bull, PHARM.D.
• David G Bunker, M.D.
• Kiley Marie Burke
• Camille Katrina Butler, MA

• Foot Surgery Podiatrist in Moline, IL
• Providers in Moline, IL by specialty
• Foot Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.