NPIMap

Organization Active NPI

Bella Healthcare LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Tempe, AZ
National Provider Identifier
1386065183
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
BELLA HEALTHCARE LLC
Practice address
1001 E Warner Rd
Ste 107
Tempe, AZ 85284-3224
Phone
(480) 897-3300
Fax
(480) 897-3312
NPI assigned
Dec 20, 2013
Last updated
Dec 20, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Authorized official

Name
Dr. Jeremy R Buckner, D.C.NPI 1104805332
Title
Ceo
Phone
(480) 897-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X AZ Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X AZ

Addresses

Primary practice location

1001 E Warner Rd
Ste 107
Tempe, AZ 85284-3224

Mailing address

1001 E Warner Rd
Ste 107
Tempe, AZ 85284-3224
Phone (480) 897-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140718002012 AZ Part B Supplier - Clinic/Group Practice 8426274978 Receives reassigned benefits from 11 practitioners
Practice locations: Tempe, AZ

National Provider Directory

National Provider Directory

Locations

1 N Central Ave
Ste 104
Phoenix, AZ 85004
Phone (602) 368-3578

4768 S Lakeshore Dr
Tempe, AZ 85282

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1386065183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E WARNER RD",
            "address_2": "STE 107",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852843224",
            "telephone_number": "480-897-3300",
            "fax_number": "480-897-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E WARNER RD",
            "address_2": "STE 107",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852843224",
            "telephone_number": "480-897-3300",
            "fax_number": "480-897-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-20",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-897-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AZ",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.