3D Integrated Medical, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

3D INTEGRATED MEDICAL, LLC

Practice address

2135 E Southern Ave
Tempe, AZ 85282-7503

Phone

(480) 456-3703

Fax

(480) 456-0477

NPI assigned

Jan 2, 2018

Last updated

Jan 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward Traum, D.C.NPI 1184762593

Title

President

Phone

(480) 456-3703

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 3

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.

• Edward A Traum, D.C.

  • Chiropractor
  • Tempe, AZ
  • NPI 1184762593
  Medicare reassignment Care Compare group NPD Authorized official
• Pamela M Traum, D.C.

  • Chiropractor
  • Tempe, AZ
  • NPI 1417095811
  Medicare reassignment Care Compare group NPD
• Michael John Peuse, DC

  • Chiropractor
  • Tempe, AZ
  • NPI 1053337527
  NPD (past)

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514851200000",
    "number": "1508373358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827503",
            "telephone_number": "480-456-3703",
            "fax_number": "480-456-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827503",
            "telephone_number": "480-456-3703",
            "fax_number": "480-456-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3D INTEGRATED MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-02",
        "last_updated": "2018-01-02",
        "status": "A",
        "authorized_official_last_name": "TRAUM",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-456-3703",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.