JACOB BUCKNER MD
NPI 1215433594
Student in an Organized Health Care Education/Training Program in Greenville, NC

Q: What is Jacob Buckner's NPI number?

The NPI number for Jacob Buckner is 1215433594. It was assigned to this individual provider in the NPPES registry on April 4, 2018.

Q: What is Jacob Buckner's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Buckner was last updated on April 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 04, 2018PECOS Enrolled

2100 STANTONSBURG RD, GREENVILLE, NC 27834(252) 744-4400 Get Directions Write a Review

NPPES record last updated: April 22, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Apr 22, 2024, Apr 11, 2018 (2 updates tracked since 2018).

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About Jacob Buckner Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB BUCKNER MD (NPI 1215433594) is an individual student in an organized health care education/training program in Greenville, North Carolina and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS and maintains a secondary practice location in San Antonio.

NPPES Registry Identity

NPI1215433594

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACOB BUCKNERCredential: MD

Location Address2100 STANTONSBURG RDGreenville, NC 27834-2818

Mailing Address6219 BroadmeadowSan Antonio, TX 78240-2261

Phone(252) 744-4400

Sole ProprietorNo

Enumeration DateApril 4, 2018

Last NPPES UpdateApril 22, 20242 updates tracked since enumeration

NPPES CertifiedApril 22, 2024

✔ NPI 1215433594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2100 STANTONSBURG RD, Greenville, NC 27834

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Secondary Practice Location 1

Location 14502 Medical DrSan Antonio, TX 78229-4402 · Phone (210) 358-4000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Buckner Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEPHEN ERIC GREGG M.D.

Student in an Organized Health Care Education/Training Program