| NPI | 1134104466 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2005-12-09 |
| Last Updated | 2025-12-30 |
| Mailing Address | Po Box 419052 Saint Louis, MO 63141-9052 United States Phone: (314) 851-1000 | Fax: (314) 851-4449 📍 View Map |
| Primary Practice Address | 13303 Tesson Ferry Rd Ste 105 Saint Louis, MO 63128-4099 United States Phone: (314) 722-2862 | Fax: (314) 722-2852 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | MO | 1134104466 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207Q00000X – Family Medicine | MO | 115447 |
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About NPI 1134104466
Brenda Lynn Buckley M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1134104466. The primary specialty listed is Family Medicine. The provider is located in Saint Louis, MO. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-12-09. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1134104466?
NPI 1134104466 belongs to Brenda Lynn Buckley M.D., a Family Medicine in Saint Louis, MO. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1134104466 active?
The current status of NPI 1134104466 in the NPPES registry is Active. The record was last updated on 2025-12-30.
What specialty is NPI 1134104466?
NPI 1134104466 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1134104466?
You can verify NPI 1134104466 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1134104466?
The primary practice address on file for NPI 1134104466 is 13303 Tesson Ferry Rd Ste 105, Saint Louis, MO 63128-4099. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1134104466 issued?
NPI 1134104466 was first issued (enumerated) on 2005-12-09. The NPPES record was last updated on 2025-12-30.
Practice Location Map
Brenda Lynn Buckley is located at 13303 Tesson Ferry Rd Ste 105, Saint Louis, MO. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Brenda Lynn Buckley. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1134104466. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Family Medicine | 115447 | MO |