Proactive Pain Treatment LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PROACTIVE PAIN TREATMENT LLC

Practice address

1001 E Warner Rd Ste 103
Tempe, AZ 85284-3224

Phone

(480) 566-9755

Fax

(480) 566-9979

NPI assigned

Apr 15, 2019

Last updated

Apr 15, 2019By 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

Jerry Buckner, DC

Title

Sole MBR

Phone

(480) 930-4018

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555286400000",
    "number": "1730742859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E WARNER RD STE 103",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852843224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E WARNER RD STE 103",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852843224",
            "telephone_number": "480-566-9755",
            "fax_number": "480-566-9979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PAIN TREATMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-15",
        "last_updated": "2019-04-15",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "480-930-4018",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cerola Guerdie Pringle, M.D.
• Emily Porter Pringle, M.A.
• Sean Printke
• Michael D Prisbrey, BS DC PA-C
• Private Healthcare Facilities
• Progressive Living Wellness Center, LLC
• Promed Providers, LLC
• Pronouncing Progress, LLC
• Erik Prossen
• Jessica Ann Prosser, LPC

• 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 Apr 15, 2019; 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.