Individual provider Active NPI

Binkolele Bukundja

  • Respite Care
  • Phoenix, AZ
National Provider Identifier
1932865904
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
License
BH6935 Issued in AZ
Practice address
7305 W Crown King Rd
Phoenix, AZ 85043-7271
Phone
(251) 487-3298
NPI assigned
Nov 12, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X BH6935 AZ Primary

Addresses

Primary practice location

7305 W Crown King Rd
Phoenix, AZ 85043-7271

Mailing address

7305 W Crown King Rd
Phoenix, AZ 85043-7271

Other identifiers 1

IdentifierTypeStateIssuer
BH6935OtherAZAZ DEPT OF HEALTH SERVICES

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
BH6935AZMDRespite Care

NPI Registry JSON

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1932865904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7305 W CROWN KING RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850437271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 W CROWN KING RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850437271",
            "telephone_number": "251-487-3298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKUNDJA",
        "first_name": "BINKOLELE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-12",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "AZ",
            "license": "BH6935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DEPT OF HEALTH SERVICES",
            "identifier": "BH6935",
            "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 Nov 12, 2021; 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.