Individual provider Active NPI

Tanner James Buenzli

  • Physical Therapist
  • Addison, TX
National Provider Identifier
1851024269
Registry record updated Jul 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1362721 Issued in TX
Practice address
15810 Midway Rd
Addison, TX 75001-4259
Phone
(972) 458-8111
NPI assigned
Jul 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1362721 TX Primary

Addresses

Primary practice location

15810 Midway Rd
Addison, TX 75001-4259

Mailing address

238 Loch Glen LN
McHenry, IL 60050-6231
Phone (815) 322-3186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1362721TXMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1656892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656892800000",
    "number": "1851024269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 LOCH GLEN LN",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600506231",
            "telephone_number": "815-322-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15810 MIDWAY RD",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014259",
            "telephone_number": "972-458-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUENZLI",
        "first_name": "TANNER",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-04",
        "last_updated": "2022-07-04",
        "certification_date": "2022-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1362721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2022; 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.