Active NPI
Jeffrey D Bundrick, DPT
- Orthopedic Physical Therapist
- Luke Afb, AZ
National Provider Identifier
1366928350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 2012027617
- Practice address
- 7219 N Litchfield Rd BLDG 1130
Luke Afb, AZ 85309-1529 - Phone
- (623) 856-2296
- NPI assigned
- Jul 13, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 2012027617 | MO | Primary |
Addresses
Primary practice location
7219 N Litchfield Rd BLDG 1130
Luke Afb, AZ 85309-1529
Mailing address
7219 N Litchfield Rd BLDG 1130
Luke Air Force Base, AZ 85309-1529
Phone (623) 856-2296
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2012027617 | Other | MO | PHYSICAL THERAPY LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012027617 | MO | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762128000000",
"number": "1366928350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7219 N LITCHFIELD RD BLDG 1130",
"city": "LUKE AIR FORCE BASE",
"state": "AZ",
"postal_code": "853091529",
"telephone_number": "623-856-2296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7219 N LITCHFIELD RD BLDG 1130",
"city": "LUKE AFB",
"state": "AZ",
"postal_code": "853091529",
"telephone_number": "623-856-2296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUNDRICK",
"first_name": "JEFFREY",
"middle_name": "D",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-13",
"last_updated": "2025-11-03",
"certification_date": "2025-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MO",
"license": "2012027617",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPY LICENSE",
"identifier": "2012027617",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Luke Afb, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.