Mesa Outpatient Treatment Center LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

MESA OUTPATIENT TREATMENT CENTER LLC

Practice address

4540 E Baseline Rd Ste 119
Mesa, AZ 85206

Phone

(480) 272-8944

NPI assigned

Jun 29, 2017

Organization subpart

No

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

Authorized official

Name

Jeremy Buckner, DC

Title

MBR

Phone

(480) 272-8944

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1316468333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD STE 119",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064617",
            "telephone_number": "480-272-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD STE 119",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-272-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA OUTPATIENT TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "480-272-8944",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mesa Obstetricians & Gynecologists, LTD
• Mesa Pain Center LLC
• Mesa Pavilions Dental LLC (Superstition Springs Dental)
• Mesa Physical Medicine PLLC
• Mesa Physician Group
• Mesa Public Schools

• Surgery Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.