NPIMap

Organization Active NPI

Sonoran Sky Pediatrics

  • Pediatrics Physician
  • Mesa, AZ
National Provider Identifier
1710139860
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SONORAN SKY PEDIATRICS
Practice address
10720 E Southern Ave
Suite 116
Mesa, AZ 85209-3810
Phone
(480) 365-0050
Fax
(480) 365-0049
NPI assigned
Oct 21, 2008
Last updated
Jul 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Authorized official

Name
Ruth E Letizia, M.D.
Title
Owner
Phone
(480) 365-0050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X AZ Primary

Addresses

Primary practice location

10720 E Southern Ave
Suite 116
Mesa, AZ 85209-3810

Mailing address

10720 E Southern Ave
Suite 116
Mesa, AZ 85209-3810
Phone (480) 365-0050

Other identifiers 4

IdentifierTypeStateIssuer
527283MedicaidAZ
088674MedicaidAZ
250599MedicaidAZ
383934MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311811200000",
    "number": "1710139860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10720 E SOUTHERN AVE",
            "address_2": "SUITE 116",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093810",
            "telephone_number": "480-365-0050",
            "fax_number": "480-365-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10720 E SOUTHERN AVE",
            "address_2": "SUITE 116",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093810",
            "telephone_number": "480-365-0050",
            "fax_number": "480-365-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONORAN SKY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2011-07-28",
        "status": "A",
        "authorized_official_last_name": "LETIZIA",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-365-0050",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "527283",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088674",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250599",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "383934",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; 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.