MRS. JESSICA BLOOM BUCKLEY (NPI# 1396828992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396828992 |
| Entity Type | Individual |
| Full Name | MRS. JESSICA BLOOM BUCKLEY |
| Other Name | JESSICA ANNE BLOOM |
| Practice Address |
3200 Maccorkle Ave Se Charleston WV 25304 |
| Mailing Address |
3 Dawn Place Charleston WV 25314 |
| Practice Telephone | 3043884077 |
| Practice Fax Number | 3043889852 |
| Mailing Telephone | 3043440949 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 163W00000X | Registered Nurse | 61450 | WV | Nursing Service Providers |
| X | 367500000X | Nurse Anesthetist, Certified Registered | 73554 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | R MEDICARE | P00274757 | 01 |
| WV | 3810004241 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043559917 | Jessica Anne Buckley | Specialist | 52 Sherbrooke Rd, Lindenhurst, NY 11757-1643 | 2013-02-12 |
| 1194036970 | Jessica Woods Buckley | Social Worker | 58 Sullivan St Unit 1, Charlestown, MA 02129-2433 | 2010-06-28 |
| 1184251035 | Jessica Leigh Buckley | Registered Nurse | 112 Southampton St, Boston, MA 02118-2711 | 2020-03-23 |
| 1861048068 | Jessica Buckley | Physical Therapist | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2019-08-13 |
| 1134635550 | Jessica Buckley | Behavior Technician | 80 Washington St Bldg P, Norwell, MA 02061-1740 | 2017-12-20 |
| 1629502174 | Jessica Buckley | Student in an Organized Health Care Education/Training Program | 33 Sylvan Ave, Apt 710, New Haven, CT 06519-1056 | 2017-04-11 |
| 1770996704 | Jessica Buckley | Physical Therapist | 4820 W Newberry Rd, Gainesville, FL 32607-2249 | 2014-06-06 |
| 1043571169 | Jessica Jean Buckley | Case Manager/Care Coordinator | 1407 Saint Andrew St, Ste 100, La Crosse, WI 54603-3301 | 2012-06-05 |
| 1518245620 | Jessica Sara Buckley | Speech-Language Pathologist | 345 Fortune Blvd, Milford, MA 01757-1723 | 2011-07-25 |
| 1396947529 | Jessica Buckley | Pediatrics | 7601 Stoneridge Dr, Kaiser Medical Office, Pleasanton, CA 94588-4501 | 2007-06-01 |
| Street Address |
3200 MACCORKLE AVE SE |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881685550 | Balakrishnan Sridharan | Internal Medicine | 3200 Maccorkle Ave Se, Hospitalists Program, Charleston, WV 25304-1227 | 2005-11-02 |
| 1982217139 | Ashley Lauren Bowles | Nurse Practitioner | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-08-27 |
| 1932717121 | Chan Myae | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-07-14 |
| 1639792971 | Victoria Morgan Bullman | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-05-21 |
| 1205459708 | Samantha Withrow | Nurse Practitioner | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-05-19 |
| 1013530567 | Jennifer D Valdez | Nurse Anesthetist, Certified Registered | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-05-19 |
| 1962025411 | Rhea N Lipscomb | Nurse Anesthetist, Certified Registered | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-05-19 |
| 1780207233 | Bethany Noel Henson | Nurse Anesthetist, Certified Registered | 3200 Maccorkle Ave Se, Charleston, WV 25304-1297 | 2020-05-19 |
| 1598388043 | Travis O Ellis | Nurse Anesthetist, Certified Registered | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-05-19 |
| 1679194849 | Joshua Zegeer | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893908 | Sade Yvonne Rice | Technician | 392 B South Parkd Rd, Charleston, WV 25304 | 2020-08-27 |
| 1053931410 | Pir Ali Shah | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 | 2020-04-25 |
| 1649807603 | Jasmine Shah | Student in an Organized Health Care Education/Training Program | 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 | 2020-03-26 |
| 1447811872 | Kwasi Amponsah Gambrah | Student in an Organized Health Care Education/Training Program | 3200 Mac Corkle Ave. Se, Robert C. Byrd Clinical Teaching Center, 5th Floor, Charlestoni, WV 25304 | 2019-06-26 |
| 1457916751 | Divya Kalluru | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast, Robert C. Bird Clinica, 4th Floor Internal Medicine Department, Charleston, WV 25304 | 2019-05-02 |
| 1841854965 | Sean Michael Percy Losier | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave., Se, Camc Family Medicine Center Robert C. Byrd Clinical Tea, Charleston, WV 25304 | 2019-04-24 |
| 1700440047 | Priyanka Chowdhry | Student in an Organized Health Care Education/Training Program | Robert C. Bird Clinical Training Center, 4th Floor, 3200 Maccorkle Avenue, Southeast, Charleston, WV 25304 | 2019-04-23 |
| 1568925469 | Saranya Dinesan | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave. Se, 4th Floor, Robert C. Byrd Clini, Charleston, WV 25304 | 2019-04-09 |
| 1043771694 | Mary Elizabeth Novak | Student in an Organized Health Care Education/Training Program | Camc Memorial Hospital, Surgicare Center, 3200 Maccorkle Ave Se, Charleston, WV 25304 | 2019-03-27 |
| 1124518600 | Abdullah Sohail | Student in an Organized Health Care Education/Training Program | 4th Floor, 3200 Maccorkle Ave, South East Robert C. Bir, Charleston, WV 25304 | 2018-05-10 |
| Find all providers in zip 25304 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073121240 | Kristen Allen Ball | Registered Nurse | 1104 Hidden Fields Way, Charleston, SC 29412-9463 | 2020-07-14 |
| 1225659766 | Lea Johnston | Registered Nurse | 1417 Swamp Fox Ln, Charleston, SC 29412-5320 | 2020-05-06 |
| 1346861937 | Devon Plumley | Registered Nurse | 21 Quarry Rdg, Charleston, WV 25304-1052 | 2020-05-05 |
| 1992346092 | Erin Kathleen O'donnell | Registered Nurse | 1483 Tobias Gadson Blvd., Suite 107, Charleston, SC 29407-4795 | 2019-10-01 |
| 1902456288 | Margaret Blincow | Registered Nurse | 15 Yeamans Rd, Charleston, SC 29407-7539 | 2019-09-18 |
| 1386162873 | Jonathan Hayes | Registered Nurse | 109 Bee St. Ralph H. Johnson Vamc, Charleston, SC 29401 | 2017-09-05 |
| 1154859502 | Florence Mack Vann | Registered Nurse | 1041 Woodside Dr, Charleston, SC 29412-9359 | 2017-05-30 |
| 1902271505 | Mary Workman | Registered Nurse | 1520 Wahington Street East, Charleston, WV 25311 | 2015-12-08 |
| 1649643727 | Jason Warren | Registered Nurse | 1020 River Haven Cir Apt O, Charleston, SC 29412-4129 | 2015-11-11 |
| 1821490962 | Shenae Ashley Long | Registered Nurse | 336 Boardwalk Dr, Charleston, SC 29414-4966 | 2014-09-19 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25304 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.