Exr4 Medical LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EXR4 MEDICAL LLC

Practice address

1984 E Baseline Rd
Tempe, AZ 85283-1535

Phone

(480) 272-8944

Fax

(480) 930-4018

NPI assigned

Sep 17, 2019

Organization subpart

No

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

Authorized official

Name

Jeremy Buckner, DC

Title

Member

Phone

(602) 421-2730

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1508416918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1984 E BASELINE RD",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831535",
            "telephone_number": "480-272-8944",
            "fax_number": "480-930-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXR4 MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-17",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "602-421-2730",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.