MR. BRADLEY WILLIAM BUCKROP DPM NPI 1558476739

NPI Information

NPI: 1558476739
Provider Name: MR. BRADLEY WILLIAM BUCKROP, DPM
Classification: Podiatrist - 213EP1101X
Entity Type: Individual

Specialization: Primary Podiatric Medicine

PECOS Registration: Yes

Address:
3727 46TH AVENUE BLACKHAWK RD
STE 103
ROCK ISLAND, IL
ZIP 61201
Phone: (309) 788-3668
Get Directions

MR. Bradley William Buckrop, DPM is a primary podiatric medicine podiatrist in Rock Island, IL. MR. Bradley William Buckrop, DPM NPI is 1558476739. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3727 46TH AVENUE BLACKHAWK RD
STE 103
ROCK ISLAND, IL
ZIP 61201-078
Phone: (309) 788-3668
Fax: (309) 786-5168

The NPI 1558476739 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 8/20/2006 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213EP1101X	Podiatrist	Primary Podiatric Medicine	016004658	ILLINOIS	Yes
2	213EP1101X	Podiatrist	Primary Podiatric Medicine	00545	IOWA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	IL0101	OTHER	ILLINOIS	JOHN DEERE HEALTH
2	8182069	OTHER	ILLINOIS	BCBS
3	00545	OTHER	IOWA	IOWA DEPT OF PUBLIC HLTH
4	016004658	MEDICAID	ILLINOIS
5	480024844	OTHER		JURISDICTION B DME MAC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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