DR. ULISA DIANE BUCKINGHAM (NPI# 1619082351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619082351 |
| Entity Type | Individual |
| Full Name | DR. ULISA DIANE BUCKINGHAM |
| Other Name | DR. U. DIANE BUCKINGHAM |
| Credential | M.D. |
| Practice Address |
200 Maine St Bert Nash Lawrence KS 66044-1368 |
| Mailing Address |
Po Box 25173 Overland Park KS 66225-5173 |
| Practice Telephone | 7858439192 |
| Mailing Telephone | 9137911292 |
| Mailing Fax Number | 9134696440 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2015-04-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
04-23312 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | FEDERAL TAX ID | 20-2932962 | 01 |
| Street Address |
200 MAINE ST BERT NASH |
| City | LAWRENCE |
| State | KS |
| Zip Code | 66044-1368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841281805 | Bert Nash Community Mental Health Center Inc | Clinic/Center | 200 Maine St, Ste A, Lawrence, KS 66044-1368 | 2005-10-31 |
| 1881223600 | Julie Cooper | Registered Nurse | 200 Maine St, Lawrence, KS 66044-1368 | 2020-04-03 |
| 1841843042 | Kristen Emanuel Rawls | Social Worker | 200 Maine St, Lawrence, KS 66044-1368 | 2019-07-17 |
| 1275186488 | Erin Walker | Social Worker | 200 Maine St, Lawrence, KS 66044-1368 | 2019-07-17 |
| 1285114876 | Connor Blake Wyckoff | Social Worker | 200 Maine St, Lawrence, KS 66044-1368 | 2018-08-14 |
| 1871085035 | Sally Gibson Ryan | Social Worker | 200 Maine St, Lawrence, KS 66044-1368 | 2018-06-04 |
| 1376045575 | Kathaleen Jo Stone | Psychologist | 200 Maine St, Lawrence, KS 66044-1368 | 2018-03-02 |
| 1881103067 | Casey Anne Pederson | Psychologist | 200 Maine St, Lawrence, KS 66044-1368 | 2017-09-20 |
| 1932639960 | Cassandra Peters Parker | Social Worker | 200 Maine St, Lawrence, KS 66044-1368 | 2017-06-13 |
| 1720516651 | Jennifer Carre' Holder | Social Worker | 200 Maine St, Lawrence, KS 66044 | 2017-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770041766 | Leslie Lynne Snow | Radiology | 325 Maine St Lawrence, Ks 66044, Lawerence, KS 66044 | 2019-03-08 |
| 1316439409 | Marjorie R Cooper Paschang | Counselor | 841 1/2 Massachusetts St Ste D, Lawrence, KS 66044 | 2018-06-04 |
| 1497255004 | Social Perspective, LLC | Social Worker | 211 E. 8th Street, #c, Lawrence, KS 66044 | 2018-02-20 |
| 1164920955 | Abby Hein | Pharmacist | 325 Maine Street, Pharmacy Dept, Lawrence, KS 66044 | 2018-01-26 |
| 1922515899 | The Magnolia Institute, LLC | Community/Behavioral Health | 729 1/2 Massachusetts. St., Suite 215, Lawrence, KS 66044 | 2018-01-02 |
| 1538615190 | Atma Clinic, LLC | Clinic/Center | 920 Massachusetts St. Ste. 3, Lawrence, KS 66044 | 2016-09-01 |
| 1497119499 | Anne Ferguson | Pharmacist | 1025 N 3rd St Ste 110, Heartland Homecare, Lawrence, KS 66044 | 2016-04-06 |
| 1467826180 | Americare At Monterey Village Assited Living LLC | Assisted Living Facility | 3901 Peterson Road, Lawrence, KS 66044 | 2015-11-18 |
| 1669886008 | Spencer Harrison | Psychiatry & Neurology | 1130 W 4th St Ste 3200, Lawrence, KS 66044 | 2014-06-13 |
| 1245658715 | Patrick Harper | Anesthesiology | 330 Arkansas St Ste 201, Lawrence, KS 66044 | 2014-04-02 |
| Find all providers in zip 66044 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760652531 | Robert Seth Gordon | Psychiatry & Neurology | 611 S Kansas Ave Ste 101, Topeka, KS 66603 | 2008-03-07 |
| 1902945934 | Mwendalubi Yasa | Psychiatry & Neurology | 1901 East First Street, Prairie View, Newton, KS 67114-0467 | 2007-02-06 |
| 1871639799 | Kansas University Physicians Inc | Psychiatry & Neurology | 1088 Delp Pavilion, Mail Stop 4015 3901 Rainbow Blvd, Kansas City, KS 66160 | 2007-01-29 |
| 1306996434 | Poonam Khanna | Psychiatry & Neurology | 14221 Metcalf Ave, Suite 123, Overland Park, KS 66223-3344 | 2007-01-11 |
| 1225067655 | M David Brown | Psychiatry & Neurology | 8300 College Blvd Ste 320, Overland Park, KS 66210-2814 | 2006-06-30 |
| 1629510417 | Wexler Family Psychiatry | Psychiatry & Neurology | 4203 Booth St, Kansas City, KS 66103-3116 | 2016-11-09 |
| 1548680507 | Caitlin Mellencamp Winder | Psychiatry & Neurology | 8000 W 127th St, Overland Park, KS 66213-2714 | 2014-04-17 |
| 1821346495 | Stacey Allison Laird | Psychiatry & Neurology | 4121 W 83rd St, Suite 204, Prairie Village, KS 66208-5472 | 2012-08-29 |
| 1851646285 | Anthony Anunwa Md Pa | Psychiatry & Neurology | 1600 N Lorraine St, Hutchinson, KS 67501-5670 | 2012-07-23 |
| 1659633709 | Larry David Mitnaul Jr. | Psychiatry & Neurology | 1515 S Clifton Ave Ste 300, Wichita, KS 67218-2953 | 2012-06-14 |
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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.