MR. WILLIAM EDWARD BUCKETT (NPI# 1851481824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851481824 |
| Entity Type | Individual |
| Full Name | MR. WILLIAM EDWARD BUCKETT |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
1054 Martin Luther King Dr Ste 124 Centralia IL 62801-3000 |
| Practice Telephone | 6185338700 |
| Practice Fax Number | 6185338701 |
| Mailing Telephone | 6185338700 |
| Mailing Fax Number | 6185338701 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2015-11-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
009118 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1054 MARTIN LUTHER KING DR STE 124 |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801-3000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942243811 | Merrilee R Brandt | Specialist | 1054 Martin Luther King Dr, Suite 125, Centralia, IL 62801-3000 | 2006-06-14 |
| 1902172372 | Karla Anne Schutzenhofer | Nurse Practitioner | 1054 Martin Luther King Dr, Suite 220, Centralia, IL 62801-3000 | 2012-03-29 |
| 1427331891 | Stephen T Ang Md Sc | Internal Medicine | 1054 Martin Luther King Dr, Ste 120, Centralia, IL 62801-3000 | 2011-09-22 |
| 1639492994 | James B. Stiehl, Md, PC | Orthopaedic Surgery | 1054 Martin Luther King Dr, Suite 226, Centralia, IL 62801-3000 | 2010-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023494226 | Sarah Pedersen | Physician Assistant | 914 South Scheuber Rd, Centralia, WA 98531 | 2015-08-11 |
| 1629527445 | Douglas Shannon | Physician Assistant | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2016-09-22 |
| 1437532710 | Eric Jahn | Physician Assistant | 914 S Scheuber Rd, 360) 736-2803, Centralia, WA 98531-9027 | 2015-07-03 |
| 1710302831 | Christi Dahlgren | Physician Assistant | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2014-02-26 |
| 1285709873 | William Millar | Physician Assistant | 1800 Cooks Hill Rd, Ste F, Centralia, WA 98531-9072 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
| 1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
| 1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
| 1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
| 1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
| 1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
| 1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
| 1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
| Find all providers with the same taxonomy | ||||
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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.