NPIMap

Organization Active NPI

Casa Grande Community Acupuncture LLC

  • Chiropractor
  • Casa Grande, AZ
National Provider Identifier
1104513803
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CASA GRANDE COMMUNITY ACUPUNCTURE LLC
Practice address
312 W 10TH St Ste 2
Casa Grande, AZ 85122-3940
Phone
(520) 222-7385
Fax
(866) 727-9116
NPI assigned
Apr 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Authorized official

Name
Aubrey Eugena Backaric, DCNPI 1760647416
Title
Owner
Phone
(520) 222-7385

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X

Addresses

Primary practice location

312 W 10TH St Ste 2
Casa Grande, AZ 85122-3940

Mailing address

474 N Oxford LN
Chandler, AZ 85225-4820
Phone (480) 822-8456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240726002955 AZ Part B Supplier - Clinic/Group Practice 5597201442 Receives reassigned benefits from 3 practitioners
Practice locations: Casa Grande, AZ

National Provider Directory

National Provider Directory

Locations

312 W 10th St
Ste 2
Casa Grande, AZ 85122
Phone (520) 222-7385

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1104513803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 N OXFORD LN",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852254820",
            "telephone_number": "480-822-8456",
            "fax_number": "866-727-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 W 10TH ST STE 2",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851223940",
            "telephone_number": "520-222-7385",
            "fax_number": "866-727-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASA GRANDE COMMUNITY ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-21",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "BACKARIC",
        "authorized_official_first_name": "AUBREY",
        "authorized_official_middle_name": "EUGENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-222-7385",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.