Active NPI
Calgary Medical LLC
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Mesa, AZ
National Provider Identifier
1740601962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 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 DirectoryNPI 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.