NPIMap

Organization Active NPI

Innovative Neuropathy Treatment Institute, PLLC

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1376923680
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
INNOVATIVE NEUROPATHY TREATMENT INSTITUTE, PLLC
Practice address
16601 N 40TH St
Suite 110
Phoenix, AZ 85032-3345
Phone
(480) 478-0780
Fax
(480) 478-0655
NPI assigned
Jun 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Authorized official

Name
Ms. Susan Doherty
Title
Managing Partner
Phone
(313) 549-0430

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Otology & Neurotology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0901X
Primary Podiatric Medicine PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213EP1101X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X

Addresses

Primary practice location

16601 N 40TH St
Suite 110
Phoenix, AZ 85032-3345

Mailing address

16601 N 40TH St
Suite 110
Phoenix, AZ 85032-3345
Phone (480) 478-4780

National Provider Directory

National Provider Directory

Locations

16601 N 40th St
Ste 110
Phoenix, AZ 85032
Phone (480) 478-0780

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443484800000",
    "number": "1376923680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16601 N 40TH ST",
            "address_2": "SUITE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323345",
            "telephone_number": "480-478-4780",
            "fax_number": "480-478-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16601 N 40TH ST",
            "address_2": "SUITE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323345",
            "telephone_number": "480-478-0780",
            "fax_number": "480-478-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE NEUROPATHY TREATMENT INSTITUTE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-09-29",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "313-549-0430",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 29, 2015; 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.