SHELLEY KAY BUFFINGTON LAC
NPI 1114956471
Counselor - Addiction (Substance Use Disorder) in Bismarck, ND
NPI Status: Active since June 30, 2006
Contact Information
515 1/2 E BROADWAY AVE STE 106
BISMARCK, ND
ZIP 58501
Phone: (701) 751-0443
Fax: (701) 751-1616
- Individual
- Female
- Years of Experience 33
- Counselor
- Addiction (Substance Use Disorder)
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About SHELLEY BUFFINGTON
This page provides the complete NPI Profile along with additional information for Shelley Buffington, a provider established in Bismarck, North Dakota with a medical specialization in Counselor, focusing in addiction (substance use disorder) and more than 33 years of experience. The healthcare provider is registered in the NPI registry with number 1114956471 assigned on June 2006. The practitioner's primary taxonomy code is 101YA0400X with license number KLE-66-4695 (ND). The provider is registered as an individual and her NPI record was last updated 4 years ago.
- NPI
- 1114956471
- Provider Name
- SHELLEY KAY BUFFINGTON LAC
- Other Name
- SHELLEY KAY KLEIN
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 515 1/2 E BROADWAY AVE STE 106 BISMARCK, ND 58501
- Location Phone
- (701) 751-0443
- Location Fax
- (701) 751-1616
- Mailing Address
- 515 E BROADWAY AVE STE 106 BISMARCK, ND 58501
- Mailing Phone
- (701) 751-0443
- Mailing Fax
- (701) 751-1616
- Medical School Name
- OTHER
- Graduation Year
- 1993
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-30-2006
- Last Update Date
- 05-04-2022
- Code Navigator
A Substance Abuse or Addiction Counselor like Shelley Buffington advices patients who experience alcoholism, drug addiction, eating disorders, mental health issues, or other mental or behavioral problems. Substance Abuse counselors provide treatment and support to help clients recover from addiction or modify problem behaviors. Many counselors incorporate the principles of 12-step programs, such as Alcoholics Anonymous (AA). They educate clients how to cope with stress and life’s issues in ways that help them recover. Counselors also help patients improve their personal relationships and find ways to discuss their addiction or other problems with family and friends.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Addiction (Substance Use Disorder)
- Taxonomy Code
- 101YA0400X
- Type
- Behavioral Health & Social Service Providers
- License No.
- KLE-66-4695
- License State
- ND
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | 834-6-1-15 (ND) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCare Bronze HSA Eligible $50 PCP Copay ($5 Value Based Drug List) - PPO
- BlueCare Gold $10 PCP Copay ($5 Value Based Drug List) - PPO
- BlueCare Silver $20 PCP Copay ($5 Value Based Drug List) - PPO
- BlueDirect Bronze 100 HSA Eligible ($8000 Deductible / $5 Preventive Drug List) - PPO
- BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
- BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
- BlueEssential Catastrophic 100 HSA Eligible $10600 Deductible - PPO
- BlueValue Bronze HSA Eligible $50 PCP Copay (Standardized plan) - PPO
- BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
- BlueValue Silver $40 PCP Copay (Standardized plan) - PPO
- Altru Prime by Medica Bronze $0 Copay PCP Visits - HMO
- Altru Prime by Medica Bronze Share - HMO
- Altru Prime by Medica Expanded Bronze Standard - HMO
- Altru Prime by Medica Gold $0 Copay PCP Visits - HMO
- Altru Prime by Medica Gold Share - HMO
- Altru Prime by Medica Gold Standard - HMO
- Altru Prime by Medica Silver $0 Copay PCP Visits - HMO
- Altru Prime by Medica Silver Share - HMO
- Altru Prime by Medica Silver Standard - HMO
- Essentia Choice Care with Medica Bronze $0 Copay PCP Visits - HMO
- Sanford Individual TRUE $1,750 - HMO
- Sanford Individual TRUE $10,600 - HMO
- Sanford Individual TRUE $3,500 - HMO
- Sanford Individual TRUE $4,750 - HMO
- Sanford Individual TRUE $6,500 - HMO
- Sanford Individual TRUE $7,200 HSA Qualified - HMO
- Sanford Individual TRUE Standardized $2,000 - HMO
- Sanford Individual TRUE Standardized $6,000 - HMO
- Sanford Individual TRUE Standardized $7,500 - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 012198 | OTHER (01) | BCBS OF ND |
Medicare Participation & PECOS Enrollment Status
Shelley Buffington is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Shelley Buffington is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 5496142507
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20240131000564
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1114956471, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 59 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114956471, enumerated as an "individual" on June 30, 2006.
The provider is located at 515 1/2 E BROADWAY AVE STE 106 BISMARCK, ND 58501 and the phone number is (701) 751-0443.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
The provider might be accepting Accepts: Blue Cross Blue Shield of North Dakota, Medica,. Please consult your insurance carrier or call the provider to verify.
