BRENDA LYNN BUCKLEY (NPI# 1134104466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134104466 |
| Entity Type | Individual |
| Full Name | BRENDA LYNN BUCKLEY |
| Credential | M.D. |
| Practice Address |
1747 Smizer Station Rd Suite 5 Fenton MO 63026-2784 |
| Mailing Address |
1747 Smizer Station Rd Suite 5 Fenton MO 63026-2124 |
| Practice Telephone | 6365297000 |
| Practice Fax Number | 6365297003 |
| Mailing Telephone | 6365297000 |
| Mailing Fax Number | 6365297003 |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2016-02-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 115447 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1134104466 | 05 |
| Street Address |
1747 SMIZER STATION RD SUITE 5 |
| City | FENTON |
| State | MO |
| Zip Code | 63026-2784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588285431 | Alisa M Perozo-dickerson | Advanced Practice Midwife | 1747 Smizer Station Rd, Fenton, MO 63026-2784 | 2020-05-01 |
| 1891238291 | Amber Lee Sorcic | Chiropractor | 1747 Smizer Station Rd, St. 4, Fenton, MO 63026-2784 | 2016-12-02 |
| 1346795234 | Chiropractic Wellness Center | Chiropractor | 1747 Smizer Station Rd, Fenton, MO 63026-2784 | 2016-08-20 |
| 1255613642 | Metro Foot Specialists, LLC | Podiatrist | 1747 Smizer Station Rd, Suite 3a, Fenton, MO 63026-2784 | 2011-09-13 |
| 1508158445 | Chiropractic Wellness Center of St Louis LLC | Clinic/Center | 1747 Smizer Station Rd, Ste. 4, Fenton, MO 63026-2784 | 2011-05-11 |
| 1255632238 | Lorenelle Lofquist | Chiropractor | 1747 Smizer Station Rd, Ste 4, Fenton, MO 63026-2784 | 2010-11-08 |
| 1023280856 | Rockwood Family Medicine LLC | Family Medicine | 1747 Smizer Station Rd, Suite 3b, Fenton, MO 63026-2784 | 2008-04-01 |
| 1770789984 | Ssm Medical Group | Clinic/Center | 1747 Smizer Station Rd, Suite 6, Fenton, MO 63026-2784 | 2007-06-25 |
| 1629295712 | Saint Louis University Dba Mark Herbers, M.d. | Pediatrics | 1747 Smizer Station Rd, Suite 6, Fenton, MO 63026-2784 | 2007-04-19 |
| 1356493811 | Fenton Family Practice, LLC | Specialist | 1747 Smizer Station Rd, Suite 5, Fenton, MO 63026-2784 | 2007-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871000372 | Allison Egler | Audiologist | 1011 Bowles Ave Ste 405, Fenton, MO 63026 | 2018-01-05 |
| 1629508213 | Holly Brooks Munson | Massage Therapist | 220 Copper Mountain Dr, Fenton, MO 63026 | 2017-06-15 |
| 1073978862 | Naomi Sharon | Nurse Practitioner | 1101 Bowles Avenue, Suite G50, Fenton, MO 63026 | 2015-12-21 |
| 1871981704 | Celtic Private Care of Il & Mo, LLC | In Home Supportive Care | 1653 Larkin Williams Road, Suite 201, Fenton, MO 63026 | 2014-12-30 |
| 1356747513 | Kristina Potts | Nurse Practitioner | 774 Gravois Bluffs Blvd Ste B, Fenton, MO 63026 | 2014-11-14 |
| 1245642420 | Physicians Health Group Medical Inc | General Practice | 960 S. Highway Dr, Fenton, MO 63026 | 2014-05-22 |
| 1598047409 | Kevin Eugene Bruce | Pharmacist | 1210 Sugar Creek, Fenton, MO 63026 | 2011-09-16 |
| 1215186382 | Concentra Health Services, Inc. | Clinic/Center | 128 Matrix Commons Dr., Fenton, MO 63026 | 2008-09-15 |
| 1790954410 | Castlewood Treatment Center LLC | Community/Behavioral Health | 1855 Bowles Ave, Suite 210, Fenton, MO 63026 | 2008-02-27 |
| 1073703617 | Christina R Baeres | Dietitian, Registered | 38 Majestic Ct, Fenton, MO 63026 | 2007-07-30 |
| Find all providers in zip 63026 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699328914 | Alegis Care - Michigan PC | Family Medicine | 1400 S Highway Dr Ste 200, Fenton, MO 63026-2281 | 2019-07-17 |
| 1518438688 | Flash Care Pllc | Family Medicine | 17100 Silver Pkwy Ste B, Fenton, MI 48430-3468 | 2018-12-16 |
| 1396163390 | Kyleigh Naismith | Family Medicine | 2420 Owen Rd Ste A, Fenton, MI 48430-3417 | 2014-04-07 |
| 1447492376 | Homebound Healthcare LLC | Family Medicine | 1076 Stone Bluff Dr, Fenton, MO 63026-8515 | 2009-03-24 |
| 1417079377 | Medcare Physician LLC | Family Medicine | 2117 Bentley Plaza, Fenton, MO 63026 | 2007-04-04 |
| 1811014491 | Joseph Lavern Trollman Jr. | Family Medicine | 201 E Caroline St, Fenton, MI 48430-2105 | 2007-03-26 |
| 1073670154 | Donna Smith Benford | Family Medicine | 1100 Torrey Rd Ste 300, Fenton, MI 48430-3327 | 2007-01-02 |
| 1194827857 | Susan H Longe | Family Medicine | 435 N Leroy St, Fenton, MI 48430-2731 | 2006-09-02 |
| 1235231077 | James S Garfield | Family Medicine | 17100 Silver Pkwy, Ste D, Fenton, MI 48430-3468 | 2006-09-02 |
| 1801998513 | Shawndra Latoya Brown-foote | Family Medicine | 128 Matrix Commons Dr, Fenton, MO 63026-2935 | 2006-09-02 |
| Find all providers in FENTON | ||||
Please comment or provide details below to improve the information on BRENDA LYNN BUCKLEY.
| 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.