NPIMap

Organization Active NPI

KD Chiropractic LLC

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1295018919
Registry record updated May 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
KD CHIROPRACTIC LLC
Practice address
10046 N Metro Pkwy W
Ste 115
Phoenix, AZ 85051-1437
Phone
(602) 674-5515
Fax
(602) 674-3029
NPI assigned
Sep 20, 2011
Organization subpart
Yes
Parent organization
KD CHIROPRACTIC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 24, 2013

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

Authorized official

Name
Dr. Jeremy Ray Buckner, DCNPI 1104805332
Title
Owner
Phone
(480) 897-3300

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

10046 N Metro Pkwy W
Ste 115
Phoenix, AZ 85051-1437

Mailing address

PO Box 11180
Tempe, AZ 85284-0020
Phone (480) 264-3744

Other names 1

  • Metro Center Chiropractic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
White Rock Chiropractic2 organizations share this tax ID, including this one
Part of
White Rock Chiropractic

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369353600000",
    "number": "1295018919",
    "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": "480-264-3744",
            "fax_number": "480-264-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10046 N METRO PKWY W",
            "address_2": "STE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511437",
            "telephone_number": "602-674-5515",
            "fax_number": "602-674-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KD CHIROPRACTIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KD CHIROPRACTIC LLC",
        "enumeration_date": "2011-09-20",
        "last_updated": "2013-05-24",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-897-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Center Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; 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.