Active NPI
Fernanda Bueno, ATC
- Athletic Trainer
- Phoenix, AZ
National Provider Identifier
1881112464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1598
- Practice address
- 1320 N 10TH St Ste B
Phoenix, AZ 85006-2710 - Phone
- (602) 839-7285
- NPI assigned
- Sep 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1598 | AZ | Primary |
Addresses
Primary practice location
1320 N 10TH St Ste B
Phoenix, AZ 85006-2710
Mailing address
2962 S Seymour
Mesa, AZ 85212-1747
Phone (480) 239-7487
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22 | Other | AZ | RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1598 | AZ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504569600000",
"number": "1881112464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2962 S SEYMOUR",
"city": "MESA",
"state": "AZ",
"postal_code": "852121747",
"telephone_number": "480-239-7487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 N 10TH ST STE B",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062710",
"telephone_number": "602-839-7285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUENO",
"first_name": "FERNANDA",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-05",
"last_updated": "2017-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "1598",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS",
"identifier": "22",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.