Organization Active NPI

Calgary Medical LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Mesa, AZ
National Provider Identifier
1740601962
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
CALGARY MEDICAL LLC
Practice address
4540 E Baseline Rd
Suite 105
Mesa, AZ 85206-4613
Phone
(480) 272-8944
Fax
(480) 237-5682
NPI assigned
Dec 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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

Authorized official

Name
Jeremy Buckner, DC
Title
Manager
Phone
(602) 889-5833

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X Primary

Addresses

Primary practice location

4540 E Baseline Rd
Suite 105
Mesa, AZ 85206-4613

Mailing address

4540 E Baseline Rd
Suite 105
Mesa, AZ 85206-4613
Phone (480) 272-8944

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387152000000",
    "number": "1740601962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD",
            "address_2": "SUITE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064613",
            "telephone_number": "480-272-8944",
            "fax_number": "480-237-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD",
            "address_2": "SUITE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064613",
            "telephone_number": "480-272-8944",
            "fax_number": "480-237-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALGARY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-16",
        "last_updated": "2013-12-16",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-889-5833",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; 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.