Bullhead Primary Care, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BULLHEAD PRIMARY CARE, LLC

Practice address

1355 Ramar Rd Ste 11a
Bullhead City, AZ 86442-7100

Phone

(928) 704-9217

NPI assigned

Mar 28, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Shakti Soni

Title

Manager

Phone

(928) 704-9217

Specialties & licenses 1

Addresses

Other names 1

• Bullhead Primary Care Doing business as

Locations

Practitioners 1

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

• Robert Bazaco Jr., MD

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1487931770
  NPD

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680048000000",
    "number": "1346944022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 RAMAR RD STE 11A",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427100",
            "telephone_number": "928-704-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 RAMAR RD STE 11A",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427100",
            "telephone_number": "928-704-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BULLHEAD PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A",
        "authorized_official_last_name": "SONI",
        "authorized_official_first_name": "SHAKTI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "928-704-9217",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bullhead Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bullhead City Hospital Corporation
• Bullhead City Hospital Corporation
• Bullhead City Senior Living, LLC
• Bullhead Family Medical LLC
• Bullhead Physical Therapy Center, LLC
• Bullhead Urgent Care Corp
• Jonathan Burch, M.A., L.P.C.
• Kerry D Burgess, DMD
• Jennifer Diane Burns
• Kim A Butler, P.A.-C

• General Practice Physician in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.