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  7. NPI Record 1336846351

MRS. LACEY DEYANNE BUCKHANNON
Complete NPI Record 1336846351
Pharmacy Technician in Champaign, IL

NPI Status: Active since February 09, 2023

Contact Information

1509 S NEIL ST
CHAMPAIGN, IL
ZIP 61820
Phone: (217) 351-1516

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Other Last Name
  8. Provider Other First Name
  9. Provider Other Middle Name
  10. Provider Other Last Name Type Code
  11. Provider First Line Business Mailing Address
  12. Provider Business Mailing Address City Name
  13. Provider Business Mailing Address State Name
  14. Provider Business Mailing Address Postal Code
  15. Provider Business Mailing Address Country Code If outside U S
  16. Provider Business Mailing Address Telephone Number
  17. Provider First Line Business Practice Location Address
  18. Provider Business Practice Location Address City Name
  19. Provider Business Practice Location Address State Name
  20. Provider Business Practice Location Address Postal Code
  21. Provider Business Practice Location Address Country Code If outside U S
  22. Provider Business Practice Location Address Telephone Number
  23. Provider Enumeration Date
  24. Last Update Date
  25. Provider Gender Code
  26. Healthcare Provider Taxonomy Code 1
  27. Provider License Number 1
  28. Provider License Number State Code 1
  29. Healthcare Provider Primary Taxonomy Switch 1
  30. Is Sole Proprietor
  31. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1336846351. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1336846351
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: LACEY
The first name of the provider, if the provider is an individual.
Provider Middle Name: DEYANNE
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: MRS.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Other Last Name: HUMES
Other last name by which the provider being identified is or has been known.
Provider Other First Name: LACEY
Other first name by which the provider being identified is or has been known (if an individual). This may be the same as the "Provider first name" if the provider is or has been known by a different last name only.
Provider Other Middle Name: DEYANNE
Other middle name by which the provider being identified is or has been known (if an individual). This may be the same as the "Provider middle name" if the provider is or has been known by a different last name only.
Provider Other Last Name Type Code: 1
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 480 MACON ST
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: MAHOMET
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: IL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 618539421
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 2177218731
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider First Line Business Practice Location Address: 1509 S NEIL ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: CHAMPAIGN
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: IL
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 618206580
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 2173511516
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 2/9/2023
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 2/9/2023
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 183700000X
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 049137234
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 1: IL
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 1: Y
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Sole Proprietor: N
Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
NPI Certification Date: 2/9/2023
The date on which the National Provider Identifier (NPI) was officially assigned and certified to the provider. This reflects when the provider's NPI record first became active in the NPPES system.