NICOLE BUCKINGHAM (APRN-CNP) – Gerontology Nurse Practitioner, NPI 1053906156

NICOLE BUCKINGHAM (APRN-CNP) is a healthcare provider. based in Miamisburg, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN-CNP. They hold a License No. APRN.CNP.0028465 (OH). The NPI Number for NICOLE BUCKINGHAM (APRN-CNP) is 1053906156

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE BUCKINGHAM (APRN-CNP)
NPI
1053906156
Phone
(937) 762-1310
Address
1 PRESTIGE PL STE 550
Enumeration Date
2 March 2021
Last Update Date
19 December 2023

Doctor Profile

Medical School Name
UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Secondary Phone
9372987751
Graduation Year
2020 (6 years ago)
PAC ID
2961818422
Group Practice PAC ID
3173710936
Professional Enrollment ID
I20210308001336
Address ID
OH454292405KE4441XAVEX400
Telehealth
Yes

Contacts

Secure Messaging
nbuckingham5864@direct.ketteringhealth.org
FHIR Endpoint
https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Other namesUpdated within 12 months

14,984 NURSE PRACTITIONER in OH

Provider Addresses for NICOLE BUCKINGHAM (APRN-CNP)

  • 1 PRESTIGE PL STE 550

    MIAMISBURG, OH 453426115

    Phone: (937) 762-1310

    Fax: (937) 522-8068

    Type: Mailing

  • 3535 PENTAGON BLVD STE 400

    BEAVERCREEK, OH 454311705

    Phone: (855) 500-2873

    Fax: (937) 490-2267

    Type: Location

  • 600 W Main St Ste 103

    Troy, OH 453733384

    Phone: (855) 500-2873

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $180.

Total Amount is formed as General ($180) + Research ($0) + Ownership ($0) = $180.

Last reported payment date: 2024-09-24 • Largest payer in this snapshot: Myriad Genetic Laboratories, Inc. ($103).

Total Amount

$180

General + Research + Ownership

Payments

3

Total payment records

General Amount

$180

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-24

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-03-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210308001336INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes228168$0
99213Established patient office or other outpatient visit, 20-29 minutes5048$0
View full utilization report →

Insurance plans in this area (ZIP 45342)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173710936View full group profile
NameSpecialtyState
Geriatric Medicine, Hematology/OncologyIL
Nurse PractitionerOH
Hematology/Oncology, Internal MedicineOH
Radiation OncologyOH
Nurse PractitionerOH
O B S T E T R I C S/ G Y N E C O L O G YOH
Orthopedic SurgeryOH
Pulmonary Disease, Critical Care (Intensivists), Sleep MedicineOH
Physician AssistantOH
Hospitalist, Emergency MedicineOH

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How do I look up NICOLE BUCKINGHAM (APRN-CNP) by NPI?
Use NPI 1053906156 when you need to reference NICOLE BUCKINGHAM (APRN-CNP) in forms, claims, or directories.
Is NICOLE BUCKINGHAM (APRN-CNP)'s NPI currently valid?
The extract we use shows NICOLE BUCKINGHAM (APRN-CNP) as active.
What kind of provider is NICOLE BUCKINGHAM (APRN-CNP)?
The page reflects Gerontology Nurse Practitioner for NICOLE BUCKINGHAM (APRN-CNP). Clinical services aligned with this taxonomy classification.
What location shows for NICOLE BUCKINGHAM (APRN-CNP)?
We surface Miamisburg, Ohio for NICOLE BUCKINGHAM (APRN-CNP) based on available NPPES addresses.
What if Miamisburg, Ohio seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

Similar Providers

ELLEN K RATAY (APRN)

Acute Care Nurse Practitioner
75 SYLVANIA DR
NPI: 1114260270
447 TIMBERLEA TRL
NPI: 1639501489

JENNIFER L LAKEBERG (PNP)

Pediatric Nurse Practitioner
662 N Main St
NPI: 1295168409

PIERRE CELESTIN NKURUNZIZA (CNP)

Acute Care Nurse Practitioner
1 PRESTIGE PL
NPI: 1902214307

MRS. JENNIFER SUNDSTROM (CNP)

Primary Care Nurse Practitioner
245, Tuxworth Road, Centerville Historic District, Centerville, Montgomery County, Ohio, 45458, United States
NPI: 1528420650

ELIZABETH A COLEBANK-ANDES (AGACNP)

Adult Health Nurse Practitioner
1 PRESTIGE PL STE 550
NPI: 1407336233

RACHAEL MARIE POLAK (ACNP)

Gerontology Nurse Practitioner
22nd Street, Tech Terrace U.N.I.T., Lubbock, Lubbock County, Texas, 79410, United States
NPI: 1346882974