Sozo Lifestyle Medicine PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SOZO LIFESTYLE MEDICINE PLLC

Practice address

10045 E Dynamite Blvd Ste F130
Scottsdale, AZ 85262-3746

Phone

(480) 404-4346

Fax

(480) 781-0020

NPI assigned

Aug 23, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Mary Elizabeth Young, DONPI 1447415427

Title

Physician/Owner

Phone

(602) 570-9441

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Elizabeth Young, D.O.

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1447415427
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1669205795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10045 E DYNAMITE BLVD STE F130",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852623746",
            "telephone_number": "804-404-4346",
            "fax_number": "480-781-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10045 E DYNAMITE BLVD STE F130",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852623746",
            "telephone_number": "480-404-4346",
            "fax_number": "480-781-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOZO LIFESTYLE MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "602-570-9441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwestern Eye Center LTD
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• Dianna Soweidan, D.O
• Aubrey Rochelle Sowers, OD
• Spa-Aaah at Regent Healthcare, Inc
• Rosemary Spacek, RDH AP
• Rosalie Anne Spada, PA-C
• Jenifer M Spadafore, P.A.-C.
• Joshua P Spade, PHARMD

• General Practice Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.