BRC Chandler LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BRC CHANDLER LLC

Practice address

1475 W Chandler Blvd
Chandler, AZ 85224-6257

Phone

(480) 930-4018

NPI assigned

Feb 7, 2020

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

Sole Member

Phone

(480) 930-4018

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581033600000",
    "number": "1609408616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11180",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852840020",
            "telephone_number": "480-930-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 W CHANDLER BLVD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246257",
            "telephone_number": "480-930-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRC CHANDLER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "480-930-4018",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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 Chandler, AZ
• Providers in Chandler, 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 Feb 7, 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.