Organization Active NPI

Avondale Accident & Pain Chiropractic Center

  • Chiropractor
  • Avondale, AZ
National Provider Identifier
1144226747
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
AZ7287 Issued in AZ
Legal business name
AVONDALE ACCIDENT & PAIN CHIROPRACTIC CENTER
Practice address
11335 W Buckeye Rd
Ste C104
Avondale, AZ 85323-6814
Phone
(623) 936-6111
Fax
(623) 936-1629
NPI assigned
Jun 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Roberto Fernandez Cunanan, DC
Title
Vice President
Phone
(622) 936-6111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X AZ7287 AZ Primary

Addresses

Primary practice location

11335 W Buckeye Rd
Ste C104
Avondale, AZ 85323-6814

Mailing address

11335 W Buckeye Rd
Ste C104
Avondale, AZ 85323-6814
Phone (623) 936-6111

National Provider Directory

National Provider Directory

Locations

11335 W Buckeye Rd
Ste C104
Avondale, AZ 85323
Phone (623) 936-6111

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144226747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11335 W BUCKEYE RD",
            "address_2": "STE C104",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853236814",
            "telephone_number": "623-936-6111",
            "fax_number": "623-936-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11335 W BUCKEYE RD",
            "address_2": "STE C104",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853236814",
            "telephone_number": "623-936-6111",
            "fax_number": "623-936-1629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVONDALE ACCIDENT & PAIN CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CUNANAN",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_middle_name": "FERNANDEZ",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "622-936-6111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "AZ7287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.