NPIMap

Organization Active NPI

Southwestern Pediatrics LLC

  • Family Nurse Practitioner
  • Maricopa, AZ
National Provider Identifier
1023347150
Registry record updated Dec 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TAP3529 Issued in AZ
Legal business name
SOUTHWESTERN PEDIATRICS LLC
Practice address
21300 N John Wayne Pkwy
Ste 109
Maricopa, AZ 85139-8979
Phone
(520) 568-9500
Fax
(520) 568-9533
NPI assigned
Dec 21, 2009
Last updated
Dec 21, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWESTERN PEDIATRICS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 21, 2009

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

Authorized official

Name
Sultan Ayoub, FNPNPI 1679803258
Title
Family Nurse Practioner
Phone
(520) 568-9500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X TAP3529 AZ Primary

Addresses

Primary practice location

21300 N John Wayne Pkwy
Ste 109
Maricopa, AZ 85139-8979

Mailing address

2730 S Val Vista Dr
Ste 161
Gilbert, AZ 85295-1675
Phone (480) 857-6316

National Provider Directory

National Provider Directory
Tax ID family
Southwestern Pediatrics PLLC4 organizations share this tax ID, including this one
Part of
Southwestern Pediatrics PLLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261353600000",
    "number": "1023347150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DR",
            "address_2": "STE 161",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951675",
            "telephone_number": "480-857-6316",
            "fax_number": "480-857-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 N JOHN WAYNE PKWY",
            "address_2": "STE 109",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851398979",
            "telephone_number": "520-568-9500",
            "fax_number": "520-568-9533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN PEDIATRICS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWESTERN PEDIATRICS LLC",
        "enumeration_date": "2009-12-21",
        "last_updated": "2009-12-21",
        "status": "A",
        "authorized_official_last_name": "AYOUB",
        "authorized_official_first_name": "SULTAN",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTIONER",
        "authorized_official_telephone_number": "520-568-9500",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP3529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maricopa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; 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.