Anr Diagnostic LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

ANR DIAGNOSTIC LLC

Doing business as

Advanced Neurologic Rehabilitation

Practice address

3961 E Guadalupe Rd Ste 1
Gilbert, AZ 85234-3266

Phone

(480) 699-4845

NPI assigned

Sep 10, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Jefferson Wayne Holm, PT, DPTNPI 1740622109

Title

President & Ceo

Phone

(602) 854-3644

Specialties & licenses 1

Addresses

Other names 1

• Advanced Neurologic Rehabilitation Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

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

• Joshua Tony Bodrero, DO

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1528564440
  Medicare reassignment NPD
• Jefferson Wayne Holm, DPT, PT, CBIS

  • Neurology Physical Therapist
  • Gilbert, AZ
  • NPI 1740622109
  NPD Authorized official

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1467288159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3961 E GUADALUPE RD STE 1",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343266",
            "telephone_number": "480-699-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3961 E GUADALUPE RD STE 1",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343266",
            "telephone_number": "480-699-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANR DIAGNOSTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "JEFFERSON",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "602-854-3644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Neurologic Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Diagnostic Radiology Physician in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Diagnostic Radiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.