Organization Active NPI

Blue Streak Investments LLC

  • Chiropractor
  • Mesa, AZ
National Provider Identifier
1831134550
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BLUE STREAK INVESTMENTS LLC
Practice address
4121 E Valley Auto Dr
Suite 110
Mesa, AZ 85206-4631
Phone
(480) 396-2225
Fax
(480) 396-1099
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
David Lloyd Ross
Title
Owner
Phone
(480) 396-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

4121 E Valley Auto Dr
Suite 110
Mesa, AZ 85206-4631

Mailing address

4121 E Valley Auto Dr
Suite 110
Mesa, AZ 85206-4631
Phone (480) 396-2225

Other names 1

  • Back USA Doing business as

National Provider Directory

National Provider Directory

Locations

4121 E Valley Auto Dr
Ste 110
Mesa, AZ 85206
Phone (480) 892-1122

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831134550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 E VALLEY AUTO DR",
            "address_2": "SUITE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064631",
            "telephone_number": "480-396-2225",
            "fax_number": "480-396-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 E VALLEY AUTO DR",
            "address_2": "SUITE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064631",
            "telephone_number": "480-396-2225",
            "fax_number": "480-396-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE STREAK INVESTMENTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-396-2225"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back USA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 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.