Jeremy Ray Buckner, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

7490 Issued in AZ

Practice address

4540 E Baseline Rd Ste 105
Mesa, AZ 85206-4616

Phone

(480) 819-0393

Fax

(480) 536-9170

NPI assigned

Jan 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Physicians Group PLLCGroup PAC ID 8426139213, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premier Physicians Group, PLLC

  • Pain Clinic/Center
  • Mesa, AZ
  • NPI 1568643047
  Medicare reassignment Care Compare group
• Ray Healthcare, LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Tempe, AZ
  • NPI 1598255366
  NPD Authorized official
• KD Chiropractic LLC

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1295018919

  Chiropractor

  NPD (past) Authorized official
• KD Healthcare LLC

  • Physical Medicine & Rehabilitation Physician
  • Tempe, AZ
  • NPI 1780014621

  Chiropractor

  NPD (past) Authorized official
• Next Level Facility LLC

  • Interventional Pain Medicine Physician
  • Phoenix, AZ
  • NPI 1558135756
  NPD

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1104805332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11180",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852840020",
            "telephone_number": "480-897-3300",
            "fax_number": "480-897-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064616",
            "telephone_number": "480-819-0393",
            "fax_number": "480-536-9170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 E Warner Rd",
            "address_2": "Suite 107",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852843224",
            "country_code": "US",
            "telephone_number": "480-897-3300",
            "fax_number": "480-897-3312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "JEREMY",
        "middle_name": "RAY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AZ",
            "license": "4180",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas R Buckley, DDS
• Klayton Buckley, CCP
• Rachael Buckley, NP
• Michael Arthur Buckmire, MD
• Alicia Buckner, P.A. - C
• Karen Marie Buckner
• Paige Buehler, RN
• Melynda Sue Buell, PA-C
• Ramon V Buenaver, MD
• Holly Rebecca Buhler, L.M.T, M.M.P.

• Chiropractor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.