MR. SAMUEL LEE BUCKLEY III (NPI# 1265919120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265919120 |
| Entity Type | Individual |
| Full Name | MR. SAMUEL LEE BUCKLEY III |
| Credential | EMT |
| Practice Address |
1200 N Telegraph Rd # Bdlg32e Pontiac MI 48341-1032 |
| Practice Telephone | 2484512600 |
| Mailing Telephone | 2484512600 |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2018-07-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 146N00000X | Emergency Medical Technician, Basic | 1921745 | MI | Emergency Medical Service Providers |
| Street Address |
1200 N TELEGRAPH RD # BDLG32E |
| City | PONTIAC |
| State | MI |
| Zip Code | 48341-1032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415837 | Brittany Taylor Shandor | Registered Nurse | 32 East, 1200 Telegraph Rd, Pontiac, MI 48341 | 2020-10-22 |
| 1013534999 | Siddharth Chopra | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue Saint Joseph Mercy Oakland Hospit, Medical Education H-23, Pontiac, MI 48341 | 2020-06-26 |
| 1972120962 | Tara Elizabeth Bjorklund | Obstetrics & Gynecology | 44405 Woodward Ave - H23, St. Joseph Mercy Oakland - Gme Office, Pontiac, MI 48341 | 2020-06-25 |
| 1245856145 | Sarah Fatima | Student in an Organized Health Care Education/Training Program | St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-17 |
| 1407471188 | Tyler Schaefer | Emergency Medical Technician, Basic | 32east 1200 N. Telegraph Rd., Pontiac, MI 48341 | 2020-06-09 |
| 1639793581 | Yash Kirankumar Varma | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-05 |
| 1326661687 | Fnu Kavita | Student in an Organized Health Care Education/Training Program | C/o Shelly Casey, St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue Medical Education - H23, Pontiac, MI 48341 | 2020-05-21 |
| 1801452578 | Lolita Curry | Registered Nurse | 32 East 1200 Telegraph, Pontiac, MI 48341 | 2019-05-17 |
| 1619530060 | Priyadarshini Dixit | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, St. Joseph Mercy Oakland Hospita, Pontiac, MI 48341 | 2019-04-20 |
| 1891358370 | Anil Gurpersaud | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave., St. Joseph Mercy Oakland, Pontiac, MI 48341 | 2019-04-19 |
| Find all providers in zip 48341 | ||||
| Taxonomy Code | 146N00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Basic |
| A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407471188 | Tyler Schaefer | Emergency Medical Technician, Basic | 32east 1200 N. Telegraph Rd., Pontiac, MI 48341 | 2020-06-09 |
| 1972012862 | Noah Lee Lesner | Emergency Medical Technician, Basic | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2017-09-24 |
| 1033634720 | Ryan Crawfis | Emergency Medical Technician, Basic | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2017-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938001 | Thomas Merkle | Emergency Medical Technician, Basic | 1036 Bowen Ln, Quincy, MI 49082-8407 | 2020-06-25 |
| 1780225169 | Clarissa Marie Baraiac | Emergency Medical Technician, Basic | 26366 Wolverine St, Madison Heights, MI 48071-3714 | 2019-10-07 |
| 1265092589 | Mari I Debolt | Emergency Medical Technician, Basic | 123 N Pine St, Saint Louis, MI 48880-1428 | 2019-06-18 |
| 1144737594 | Taylor Hoekwater | Emergency Medical Technician, Basic | Central Michigan University Health Professions Ofc 1205, Mount Pleasant, MI 48859-0001 | 2018-01-08 |
| 1518418730 | Tamica K Boyd | Emergency Medical Technician, Basic | 15890 Lamphere, Detroit, MI 48223 | 2016-10-24 |
| 1639543374 | Tyler Alley | Emergency Medical Technician, Basic | 4267 Monroe St, Ecorse, MI 48229-1519 | 2015-11-18 |
| 1497122881 | Kyle Andre St. Peter | Emergency Medical Technician, Basic | 41641 Utica Rd, Sterling Heights, MI 48313-3264 | 2015-09-01 |
| 1205242294 | Pennfield Twp Fire Dept | Emergency Medical Technician, Basic | 20260 Capital Ave Ne, Battle Creek, MI 49017-9727 | 2014-07-10 |
| 1669731998 | Michael Anthony Wilk | Emergency Medical Technician, Basic | 188 W Spruce St, Saint Ignace, MI 49781-1649 | 2012-05-07 |
| 1659340966 | Michael Alan Seger | Emergency Medical Technician, Basic | 4700 Canal Ave Sw, Grandville, MI 49418-9724 | 2006-03-17 |
| 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.