MRS. JOHANNA LYDIA BUCK (NPI# 1396898441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396898441 |
| Entity Type | Individual |
| Full Name | MRS. JOHANNA LYDIA BUCK |
| Credential | MS, PT |
| Practice Address |
400 Crater Lake Ave Medford OR 97504-6808 |
| Practice Telephone | 5416136505 |
| Practice Fax Number | 5417709212 |
| Mailing Telephone | 5416136505 |
| Mailing Fax Number | 5417709212 |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2019-02-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
05897 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
400 CRATER LAKE AVE |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-6808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346876257 | Kelly Marie Barlow | Registered Nurse | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2020-03-23 |
| 1568971315 | Rebecca Meador | Occupational Therapist | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2017-09-25 |
| 1821526914 | Sound Music Therapy, LLC. | Music Therapist | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2017-06-01 |
| 1689105454 | Yvette Provosty | Physical Therapist | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2017-03-23 |
| 1467995084 | Neurotherapeutic Pediatric Therapies, Inc | Physical Therapist | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2016-11-30 |
| 1417346511 | Audrie Kingzett | Midwife | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2015-01-13 |
| 1285060517 | Heather Chalmers Faith | Midwife | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2013-09-18 |
| 1073950036 | Aimee A Disharoon | Midwife | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2013-05-31 |
| 1659629137 | Wise Women Care Associates | Midwife, Lay | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2012-08-15 |
| 1891055034 | Brenda Marie Walleman | Music Therapist | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2012-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134374226 | Carlos Villaverde Avilla | Physical Therapist | 5 Camden Ct, Medford, NY 11763-1583 | 2008-11-18 |
| 1790814200 | Susan Nicklin | Physical Therapist | 945 S Riverside Ave, Medford, OR 97501-7841 | 2007-03-02 |
| 1932238441 | Alice Bowen | Physical Therapist | 945 S Riverside Ave, Medford, OR 97501-7841 | 2007-03-02 |
| 1508995010 | Bonnie D'mello | Physical Therapist | 945 S Riverside Ave, Medford, OR 97501-7841 | 2007-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275156101 | Pace Pediatric Therapy, Inc. | Physical Therapist | 3701 Se Milwaukie Ave Ste G, Portland, OR 97202-3835 | 2020-05-27 |
| 1427691740 | First Steps Physical Therapy, LLC | Physical Therapist | 911 Main St Ste 100, Oregon City, OR 97045-1853 | 2019-10-18 |
| 1467804773 | Rebecca D. Sander | Physical Therapist | 17113 Sw Green Heron Dr, Sherwood, OR 97140-8972 | 2016-07-11 |
| 1841426434 | Rebecca Additon Veltri | Physical Therapist | 32513 Joseph Ln, Philomath, OR 97370-9130 | 2009-06-09 |
| 1396943932 | Kathleen Marie Hogan | Physical Therapist | 132 Formac Ave, Eugene, OR 97404-2606 | 2007-07-05 |
| 1306050646 | Pediatric Therapyworks | Physical Therapist | 30714 Se Dodge Park Blvd, Gresham, OR 97080-8961 | 2007-05-09 |
| 1912068941 | Sandra Lee Saavedra | Physical Therapist | 1763 Moss St, Eugene, OR 97403-1946 | 2006-12-13 |
| 1164598462 | Joy Danielle Shank | Physical Therapist | 7203 Se Raymond St, Portland, OR 97206-4323 | 2006-11-28 |
| 1861453979 | Therapy Solutions for Kids, LLC | Physical Therapist | 5200 Sw Macadam Ave, Portland, OR 97239-6103 | 2006-03-29 |
| 1225649205 | Jaclyn Silver | Physical Therapist | 2500 Ne Neff Rd, Bend, OR 97701-6015 | 2020-08-12 |
| 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.