Individual provider Active NPI

Clinton Ray Bunker, PT,DPT

  • Physical Therapist
  • Gilbert, AZ
National Provider Identifier
1881784304
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6975 Issued in AZ
Practice address
2550 E Guadalupe Rd
Suite 111
Gilbert, AZ 85234-5114
Phone
(480) 633-0666
NPI assigned
Oct 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6975 AZ Primary

Addresses

Primary practice location

2550 E Guadalupe Rd
Suite 111
Gilbert, AZ 85234-5114

Mailing address

2550 E Guadalupe Rd
Suite 111
Gilbert, AZ 85234-5114
Phone (480) 633-0666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051027001183 AZ Practitioner - Physical Therapist in Private Practice 4082631189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Farnsworth Orthopedic Physical Therapy LLCGroup PAC ID 5395729396, 5 clinicians

Practice addresses (Care Compare)

730 N Greenfield Rd
Gilbert, AZ 85234-5012
Phone (480) 633-0666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6975AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Farnsworth Orthopedic Physical Therapy, LLC Physical Therapist CurrentSince Oct 1, 2005 Accepting new patients

Locations

2550 E Guadalupe Rd
Ste 111
Gilbert, AZ 85234
Phone (480) 633-0666

730 N Greenfield Rd
Gilbert, AZ 85234
Phone (480) 633-0666

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881784304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 E GUADALUPE RD",
            "address_2": "SUITE 111",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852345114",
            "telephone_number": "480-633-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 E GUADALUPE RD",
            "address_2": "SUITE 111",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852345114",
            "telephone_number": "480-633-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNKER",
        "first_name": "CLINTON",
        "middle_name": "RAY",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.