Individual provider Active NPI

Blair Gregory Bundy, DPT

  • Physical Therapist
  • Scottsdale, AZ
National Provider Identifier
1083045827
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11479 Issued in AZ
Practice address
9917 N 95TH St
Scottsdale, AZ 85258-4586
Phone
(480) 314-1533
Fax
(480) 314-5795
NPI assigned
Dec 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 1227055 TX
Physical Therapist 225100000X 11479 AZ Primary

Addresses

Primary practice location

9917 N 95TH St
Scottsdale, AZ 85258-4586

Mailing address

9917 N 95TH St
Scottsdale, AZ 85258-4586
Phone (480) 314-1533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11479AZMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1083045827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9917 N 95TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584586",
            "telephone_number": "480-314-1533",
            "fax_number": "480-314-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9917 N 95TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584586",
            "telephone_number": "480-314-1533",
            "fax_number": "480-314-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDY",
        "first_name": "BLAIR",
        "middle_name": "GREGORY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-04",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "TX",
            "license": "1227055",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "11479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.